RESUMO
Hepaticojejunoanastomosis (HJÐ), using the HF-еlectric welding method, was formatted in 14 patients, suffering the bile outflow disorders along main biliary ducts, in 6 of them - with a common hepatic duct stricture, the HJA stricture, purulent cholangitis, iatrogenic injury of biliary ducts, and in 8 with malignant tumours of periampullary zone. In all the patients the welding averting one-layer termino-lateral or latero-lateral HJÐ were formatted. Welding anastomoses were hermetic, quite hard, immediately after formation and so on. Comparative analysis of clinic-laboratory postoperative indices has confirmed the best results achievement of the method proposed.
Assuntos
Anastomose Cirúrgica/métodos , Ducto Colédoco/cirurgia , Eletrocoagulação/métodos , Jejuno/cirurgia , Fígado/cirurgia , Técnicas de Sutura/instrumentação , Anastomose Cirúrgica/instrumentação , Neoplasias dos Ductos Biliares/patologia , Neoplasias dos Ductos Biliares/cirurgia , Colangite/patologia , Colangite/cirurgia , Ducto Colédoco/patologia , Constrição Patológica/patologia , Constrição Patológica/cirurgia , Eletricidade , Eletrocoagulação/instrumentação , Feminino , Humanos , Fígado/patologia , Masculino , Ondas de Rádio , Supuração/patologia , Supuração/cirurgia , Suturas , Resultado do TratamentoRESUMO
Modern classifications of lymph nodes of the hepatopancreatobiliary zone organs, applied by domestic and leading foreign surgeons were analyzed. A modified classification of lymph nodes was proposed, basing on recommendations of Japanese society of pancreatologists (V edition). Basing on own experience, the results of studying of the lymph nodes groups and extent of lymphadenectomy in patients while presence of malignant tumors of pancreas and distal portion of common biliary duct were analyzed.
Assuntos
Adenocarcinoma/cirurgia , Neoplasias do Ducto Colédoco/cirurgia , Linfonodos/patologia , Linfonodos/cirurgia , Neoplasias Pancreáticas/cirurgia , Adenocarcinoma/irrigação sanguínea , Adenocarcinoma/patologia , Ducto Colédoco/irrigação sanguínea , Ducto Colédoco/patologia , Ducto Colédoco/cirurgia , Neoplasias do Ducto Colédoco/irrigação sanguínea , Neoplasias do Ducto Colédoco/patologia , Humanos , Excisão de Linfonodo/métodos , Linfonodos/irrigação sanguínea , Metástase Linfática , Pâncreas/irrigação sanguínea , Pâncreas/patologia , Pâncreas/cirurgia , Neoplasias Pancreáticas/irrigação sanguínea , Neoplasias Pancreáticas/patologiaRESUMO
Abstract Own experience of treatment of patients for biliary calculous disease, coexistent with other abdominal and retroperitoneal organs diseases, was analyzed. The rate of postcholecystectomy syndrome (PCHES) occurrence in such patients was determined, the impact of simultant operative interventions using laparoscopic and laparotomic accesses on the rate of the PCHES occurrence was established. The elaborated diagnostic-treatment algorithm with application of measures, directed on the PCHES prophylaxis, was elaborated. There was established, that performance of simultant operations in accordance to strict indications secures a trustworthy reduction of the PCHES occurrence rate.
Assuntos
Colecistectomia Laparoscópica/métodos , Colelitíase/cirurgia , Cistos/cirurgia , Síndrome Pós-Colecistectomia/prevenção & controle , Glândulas Suprarrenais/cirurgia , Ductos Biliares/cirurgia , Colecistectomia Laparoscópica/efeitos adversos , Colelitíase/patologia , Cistos/patologia , Feminino , Humanos , Fígado/cirurgia , Masculino , Mediastino/cirurgia , Ovário/cirurgia , Pâncreas/cirurgia , Síndrome Pós-Colecistectomia/etiologia , Estudos Retrospectivos , Útero/cirurgiaRESUMO
Own experience of treatment of the common biliary duct cysts was analyzed in the patients, to whom earlier noneffective operative procedures for this purpose were performed. The main causes of the operations faults were unmasked, the proposed treatment-diagnostic algorithm was proposed, immediate and remote results of operative treatment were analyzed.