[The pancreaticogastroanastomosis by pancreatoduodenal resection].

The 10 year experience of pancreatoduodenal resection, consisting of 63 operations was analyzed by the authors. The reconstructive stage of the operation included pancreaticojejunoanastomosis in 20 patients and pancreaticogastroanastomosis in the original modification in 43 patients. The method included the tamponization of the pancreatic stump with the mucosa layer of the gastric back wall. The suggested way of the pancreaticogastrostomy proved to shorten the operative time without increasing the postoperative morbidity and mortality rates.

[Repeated surgical operations for disseminated purulent peritonitis].

Results of surgical treatment were analyzed in 65 patients with disseminated purulent peritonitis (DPP). 34 patients undergoing re-laparotomy "on demand" formed the first group. 31 patients undergoing programmed re-laparotomy formed the second group. Lethality was higher in the first group (59% compared with 29% in the second group; p = 0.024). Risk of lethal outcome was higher in 2.5 times in patients from the first group (p = 0.030). Survival rate was evaluated using APACHE II scale, but the distinctions between two groups were not statistically significant (p = 0.178). According to APACHE II scale high indices were observed in deceased patients from both groups (26.1 +/- 8.9 in the first group, 19.7 +/- 5.9 in the second group; p = 0.009). Indications for programmed planned abdominal cavity sanation and laparostoma surgery in patients with DPP are described. Authors suggest that programmed sanations substantially improve the results of treatment in patients with DPP compared with re-laparotomy "on demand".

[Surgical treatment of patients with acute pancreatitis].

Results of treatment of patients with acute pancreatitis are analyzed. Efficacy of staged treatment of patients with acute destructive pancreatitis is demonstrated. The ineffective conservative therapy during 1-3 days is regarded as indication for half-open surgical method (median laparotomy, necrsecvestrectomy, omentopancreatobursostoma and lumbostoma formation). General purulent peritonitis is indication for open method (laparostoma formation). Unitized surgical tactics permitted to reduce lethality from 4.2 to 2.5%.

[Effect of low-frequency ultrasound on the course of the wound process]. / Vliianie nizkochastotnogo ul'trazvuka na techenie ranevogo protsessa.

By the methods of clinical and morphological investigations as well as by measurements of the wound medium pH it was established that the application of low-frequency ultrasound for the treatment of purulent wounds accelerated necrolysis, decreased bacterial contamination of the wound, normalised the microcirculation system, activated the macrophagal reaction, increased the proliferative and synthetic activity of fibroblasts, collagen fibrillogenesis and contributed to a sharp shortening of the hydratation phase which resulted in the earlier closing of the wound.

[Low-frequency ultrasonics in the treatment of trophic ulcers]. / Ispol'zovanie nizkochastotnogo ul'trazvuka v lechenii troficheskikh iazv.

The treatment of trophic ulcers by the low-frequency ultrasound results in destruction of the collagen fibres of the fibro-cicatricial tissue, reduces the bacterial dissemination, stimulates the growth of a new granulation tissue which allows to fulfill autodermoplasty .

[Intra-arterial regional perfusion in destructive forms of acute pancreatitis]. / Vnutriarterial'naia regionarnaia perfuziia pri destruktivnykh formakh ostrogo pankreatita.

The results of using regional infusion therapy in 17 patients with destructive pancreatitis are analyzed which appeared to be more effective, than the systemic infusion of drugs in stopping the symptoms of endotoxicosis leveling the functional insufficiency of the liver and kidneys, disturbances in hemodynamics and hemostasis. The best results have been obtained when using a modified method of regional therapy (celiac-aortal dislocational regional infusion) in the complex treatment of destructive pancreatitis. This method has a number of advantages as compared with intra-aortic variant of regional therapy. Hospital lethality in the process of using the methods of regional therapy in the complex treatment of destructive pancreatitis was 17.5%. In the control group of patients treated without regional infusion lethality was within the limits of 28%. A modified classification of endotoxicosis according to the degree of the disease is proposed. In order to estimate the severity of the syndrome of intoxication and effectiveness of the given therapy principally new integrative parameters of clinical and laboratory research are used.