[Laparoscopic adrenalectomy in surgery of the adrenal gland diseases].

In 2002-2012 yrs in The Department of Laparoscopic Surgery and Choledocholithiasis laparoscopic adrenalectomy (LA) for various adrenal gland diseases was done in 94 patients. The operation time while doing right-sided and left-sided LA have had constituted, accordingly, at average (73.6 +/- 12.1) and (121.6 +/- 11.9) min, intraoperative blood loss - (49.3 +/- 9.2) ml. Hemotransfusion was not applied. There was no need for conversion. In 1 (1,1%) patient hemoperitoneum have had occurred as a consequence of traumatic injury of spleen while performing left-sided LA. Nonspeciphic postoperative complications were absent.

[Possibilities of transpapillary and laparoscopic methods of choledocholithiasis treatment].

The results of surgical treatment of patients, suffering choledocholithiasis, were adduced. In 493 patients laparoscopic exploration of common biliary duct was accomplished, in 297 of them the choledocholithiasis diagnosis was definitely established while performing laparoscopic cholecystectomy (LCHE); in 136--endoscopic papillosphincterotomy (EPST) was done preoperatively, but the attempts to perform transpapillary lithoextraction and lithotripsy have failed; in 60--a residual choledocholithiasis was noted. In 930 patients EPST and lithoextraction were performed preoperatively and as a second stage--LCHE.

[Mini-invasive interventions for cystic formations of the spleen].

The data of complex clinical examination and surgical treatment of 89 patients, having splenic cysts (SC), are analyzed. Indications and contraindications for miniinvasive methods of treatment (laparoscopic and puncture-draining procedures under ultrasonographic control) application are substantiated, taking into account their size, localization, pathogenesis and presence of SC complications. Diagnostic efficacy of abdominal ultrasonography, computer tomography for SC was estimated, the significance of these methods, while choosing a rational tactics of treatment, was determined. There were elaborated and introduced into clinical practice the stages of endosurgical procedures, including performance of organpreserving operations for SC. Introduction of the elaborated diagnostic algorithm and tactics of treatment of SC have permitted to reduce postoperative complications rate and the patients stay in hospital, improving their quality of life as well.

[Experience of performance of laparoscopic adrenalectomy using lateral transabdominal approach].

In 2002-2008 yrs. in the Department of Laparoscopic Surgery and Cholelithiasis in 52 patients laparoscopic adrenalectomy (LA) was accomplished, performed for different diseases of suprarenal glands. Incidentaloma was diagnosed in 8, fibroma--in 4, pheokhromocytoma--in 10, aldosteroma--in 11, adrenocortical cancer--in 3, corticosteroma--in 13, suprarenal gland cyst--in 3 patients. The operation time in right-sided and left-sided LA had constituted accordingly 85 and 118 minutes. Intraoperative blood loss had constituted 60 ml at average. Hemotransfusion was not done. In 1 (2.4%) observation hemoperitoneum had occurred as a result of traumatic damage of spleen during performance of left-sided LA. Intraoperative complications were absent. The stationary treatment duration was 2.6 days at average.

[Modern tendencies in diagnosis and treatment of an acute destructive pancreatitis].

The problem of an acute pancreatitis was one of "key" ones in investigations of A. A. Shalimov and his school. While the knowledge concerning the disease pathogenesis improved, diagnostic and treatment algorhythm elaborated, modern medicinal preparations and surgical treatment introducted, including miniinvasive technologies, so also approaches to treatment of patients, suffering an acute pancreatitis, have changed.

[Experimental substantiation of the method of biological tissue welding in surgical hepatology]. / Eksperimental'noe obosnovanie primeneniia metoda élektrosvarki biologicheskikh tkanei v khirurgicheskoi gepatologii.

Application of the welding method for biological tissues in hepatobiliary surgery was experimentally substantiated. In 14 pigs (25-30 kg body mass) resection of one hepatic lobe, using electric welding method, was done. In control group (4 pigs) the similar operative intervention was accomplished, using conventional method. Application of the electric welding method guarantees secure hemostasis and cholestasis, do not causes specific pathological changes in the adjacent region of affection tissues, speed of restoration of the structures damaged exceeds such in application of the suturing method.

[Simultaneous operations during laparoscopic cholecystectomy]. / Simultannye operatsii pri vypolnenii laparoskopicheskoi kholetsistektomii.

Simultant laparoscopic operations were performed in 1993-2003 yrs period in 321 patients, including 287--using laparoscopic and 34--the combined (laparoscopic and open) access. Concurrent diseases were diagnosed preoperatively in 219 (68.2%) of patients and were disclosed while doing intraoperative revision--in 102 (31.8%). The simultant operations performance, as a rule, enhanced mildly the total duration of a basic stage, did not influence the duration of postoperative period and the patients rehabilitation essentially, as well as for frequency of the intra--and postoperative complications occurrence. The authors consider that it is expedient to perform laparoscopic intervention simultaneously for concurrent surgical diseases of abdominal cavity.

[Effect of spore-free anaerobic microorganisms of pancreatic tissue in experimental acute pancreatitis]. / Vozdeistvie nesporoobrazuiushchikh anaérobnykh mikroorganizmov na tkan' podzheludochnoi zhelezy pri éksperimental'nom ostrom pankreatite.

The simulation model of an acute pancreatitis (AP), using translocation of microorganisms from intestine to ductal system and pancreatic tissue, was created in experiment on dogs. Interrelationships between pancreatic tissue and anaerobic microorganism in an AP were studied, using electron microscopy. Possibility of the microorganisms migration to pancreas from ductal system in early stage of AP due to enhanced reproduction of anaerobic microorganisms in duodenum was established. It is impossible to exclude the possibility of their invasion via the lymph and the blood flow into destructively changed pancreatic tissue in late terms of the disease.

[Experimental application of electrocautery in biliary surgery]. / Eksperimental'noe primenenie metoda élektrosvarki v biliarnoi khirurgii.

The testing of a new nonsuture electrothermic method of biliary system tissues connection was conducted in laboratory animals--rabbits and pigs. Reactions of tissues and cells in zone of electric influence and the gallbladder suture, remote reactive changes in the operation zone were studied up. In application of the proposed method of the regeneration processes inhibition and specific pathological changes in surrounding tissues were not noted, speed of the damage structure restoration was comparable with such in the tissues connection using suture materials.

[The meaning of interleukin-6 in chronic biliary pancreatitis]. / Znachenie interleikina-6 pri khronicheskom biliarnom pankreatite.

The interleukin-6 (IL-6) contents in the blood serum and in bile from the gallbladder was studied in 25 patients with uncomplicated cholelithic disease and with that, complicated by chronic biliary pancreatitis. Laparoscopic cholecystectomy was done in all the patients. In uncomplicated cholelithic disease IL-6 was not revealed in the blood serum and in majority of observations--in bile from gallbladder. Direct dependence was established between duration of cholelithic disease existence, complicated by chronic biliary pancreatitis, and concentration of IL-6 in bile from gallbladder.

[Application of electro-thermo-adhesion in hepatobiliary surgery]. / Primenenie metoda élektrotermoadgezii tkanei v gepatobiliarnoi khirurgii.

Since 1999 yr. 283 laparoscopic operations were performed in the clinic for diseases of liver, biliary ducts, pancreas using electrothermoadhesion method, including 201 cholecystectomies, 62--in presence of hepatic cyst, 6--enucleation of hemangioms, 3--hepatic edge resection, 1--cholecystectomy, in 10 patients the puncture biopsy of pancreas was done.

[Lessons on laparoscopic cholecystectomy (summary of the experience]. / Uroki laparoskopicheskoi kholetsistéktomii (obobshchenie opyta)].

The experience of laparoscopic cholecystectomy conduction in 6524 patients with nontumoral diseases of gallbladder (chronic calculous cholecystitis, an acute calculous cholecystitis, chronic noncalculous cholecystitis, the gallbladder polyposis) was summarized. While comparing the initial seizing experience in laparoscopic cholecystectomy in the clinic the tendency was noted, trusting the skills improvement in management of laparoscopic technique, permitting to reduce the contraindications quantity for laparoscopic cholecystectomy. Several principles were elaborated, which is necessary to follow doing laparoscopic cholecystectomy for improvement of results of treatment in patients and for complications reduction.

[Laparoscopic interventions on choledochus: 5 year experience]. / Laparoskopicheskie vmeshatel'stva na obshchem zhelchnom protoke: piatiletnii opyt.

Complex examination of 69 patients with complicated cholelithic disease was performed. The elaborated in the clinic algorithm for preoperative examination of the patients was applied to reveal the main bile ducts pathology. Indications for the laparoscopic interventions on choledochus performance were substantiated.

[Current status and trends in the development of medical information systems for morphological research]. / Sostoianie i tendentsii razvitiia meditsinskikh informatsionnykh sistem dlia morfologicheskikh issledovanii.

The time of cooperative action of the information medical systems is coming. Standardization of clinical laboratory information systems is one of the most difficult but important problems for clinical laboratory community and technicians. Electronic data exchange requires agreement on the data element format by which healthcare institutions can exchange. Computerization of health care service raises the problem of security because the risk of violation of medical privacy is dramatically increasing. Unauthorized users can access, copy, alter, delete or distort hundreds or thousands of medical records within minutes. Information can be faulted by individuals or system failure. It is necessary to discuss and make a final decision of joining some standard for the purpose of integration.

[Diagnosis of cancer of the pancreatic body and tail]. / Diagnostika raka tela i khvosta podzheludochnoi zhelezy.

Results of 194 patients observation with cancer of corpus et cauda pancreatis are adduced. Clinical forms of the disease are distinguished. Rational algorithm for the examination of patients with probable cancer of corpus et cauda pancreatis diagnosis was elaborated grounded on the efficacy analysis of various methods of examination (ultrasonic investigation, computed tomography, endoscopic retrograde cholangiopancreatography, selective, angiography and so on). The algorithm application permitted to improve significantly the diagnosis of disease.

[A rational procedure for the treatment of patients with chronic calculous cholecystitis complicated by choledocholithiasis]. / Ratsional'naia taktika lecheniia bol'nykh s khronicheskim kal'kuleznym kholetsistitom, oslozhnennym kholedokholitiazom.

The results of surgical treatment of 156 patients with chronic calculous cholecystitis complicated by choledocholithiasis have been analysed. In 62 patients, cholecystectomy in combination with choledocholithotomy was performed. Ninety four patients underwent additional drainage operations on the terminal common bile duct. Endoscopic papillosphincterotomy was performed in 90% of cases, other drainage interventions (choledochoduodenostomy and transduodenal papillosphincterotomy)--in 10%.