[Prophylaxis of an acute postoperative pancreatitis and the stress ulcers occurrence after operations, performed on organs of hepatopancreatoduodenal zone, using miniinvasive and open access].

The causes of occurrence and pathogenesis of the most frequent complications, occurring after operations, made on hepatopancreatoduodenal zone organs, using minimally invasive and open accesses, were analyzed. Efficacy of domestic preparation Famozol for prophylaxis of an acute postoperative pancreatitis and the gut stress ulcers was studied.

[Characterization of hepatic blood flow in hepatic cirrhosis].

Comparative investigation of hepatic blood flow in patients, suffering hepatic cirrhosis in compensated and decompensated stage, was performed. Characteristic peculiarities of arterial and portal hepatic blood flow were revealed, what has important diagnostic significance and must be taken in account while choosing methods of surgical and miniinvasive treatment of patients.

[Prophylaxis of injuries of biliary ducts in laparoscopic cholecystectomy: clinical recommendations of Ukrainian association of specialists for miniinvasive, endoscopic and laser technologies].

Wide introduction of laparoscopic cholecystectomy (LCHE) caused during last 20 years a significant enhancement of rate of the biliary ducts injuries (BDI). Taking into account the experience gained in performing of more than 40,000 operations of LCHE in a leading clinics, including such in a technically complex situations, as well as experience of more than 500 operations performance for BDI, clinical recommendations, based on principles of a substantiality medicine were elaborated. More than 100 sources of foreign and domestic literature were analyzed, summarizing the results of more than 150,000 operations of LCHE, special attention was drawn to the sources I (meta-analysis and prospective randomized investigations) and II (systematic reviews, thoroughly planned prospective comparative investigations) levels of substantiality. Every paragraph is accompanied by a certain level of a recommendation strength (RS, A-C). It is necessary to follow these recommendations strictly today.

[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.

[Inhibition of the stellate cells using lisinopril and lovastatin for prophylaxis of pancreatic stump fibrosis after performance of distal resection in a model of chronic alcoholic pancreatitis].

Complex application of lisinopril (inhibitor of angiotensin-converting enzyme) and lovastatin (inhibitor of HMG-CoA reductase) inhibits pancreatic fibrosis in the rats, having alcoholic chronic pancreatitis after distal pancreatic resection (DPR). Lisinopril and lovastatin were injected to the rats after DPR in dose 10 mg/kg during 3 weeks. Immunohistochemical markets, such as alpha-smooth-muscle actin (alpha-SMA), desmin, glial fibrillary acidic protein (GFAP), vimentin, and expression of matrix metalloproteinase-1 (MMP-1) as well as inhibitor of matrix metalloproteinase-2 (TIMP-2) were detected for estimation of therapeutic impact on activity and quantity of stellate pancreatic cells. Under the influence of lisinopril and lovastatin there were observed lowering in the stellate pancreatic cells activity and in expression of SMA, desmin, GFAP, vimentin and TIMP-2, the MMP-1 and TIMP-2 ratio have had increased significantly and severity of fibrotic pancreatic affection had reduced trustworthy in comparison w such, occurring in a control group.

[Application of combined antibacterial preparations in the treatment of surgical intra-abdominal infections].

Experience of application of combined preparation Ciprolet A (ciprofloxacine 500 mg, tinidazol 600 mg) in 27 patients after performed reconstructive operations for surgical diseases of abdominal organs as well as in 50 patients in destructive forms of an acute cholecystitis was summarized. Possibility of the preparation application in ambulatory conditions constitutes its advantage.

[Combined injuries of bile ducts and hepatic artery branches in cholecystectomy].

Results of treatment of 25 patients with combined injuries of bile ducts and the common hepatic artery in performing cholecystectomy were studied. In 19 (73.1%) patients the injuries were noted during open and in 7 (26.9%) patients during laparoscopic cholecystectomy. The patients needed multimodal strategy of treatment with reference to the time when the diagnosis was made and to the characteristics of clinical course. Positive results of treatment were obtained in 84.6% of cases, lethality made up 3.9%.

[Application of essential phospholipids in the treatment and prophylaxis of postcholecystectomy syndrome].

The experience of drug use in the clinic Enerliv (of "Berlin - Chemie Menarini" Germany) in 58 patients is the complex treatment of postcholecystectomy syndrome in generalised. The drug has hepatoprotective and cholesterol-lowering effect, effectively eliminates pain and dyspeptic symptoms, normalize biochemical parameters.

[Inhibition of pancreatic stellate cell activation by lisinopril for prevention fibrogenesis in experimental chronic alcoholic pancreatitis].

Lisinopril (angiotensin-converting enzyme inhibitor) attenuates fibrotic changes in pancreas after distal pancreatectomy in rats with experimental alcohol induced chronic pancreatitis. Lisinopril was administered after distal pancreatectomy in rats with experimental alcohol induced chronic pancreatitis. The animals were treated with lisinopril at the dose of 10 mg/kg body weight per day for 21 days after operation. To estimate the efficacy of the treatment on activity and number of pancreatic stellate cells the immunohistochemical investigation was made with alpha-smooth muscle actin (alpha-SMA), desmin, vimentin, glial fibrillary acidic protein (GFAP), matrix metalloproteinase-1 (MMP-1), tissue inhibitor of metalloproteinase-2 (TIMP-2) using. The treatment of rats after operation with lisinopril inhibite activity of pancreatic stellate cells and characterized by significant decrease of the alpha-SMA, desmin, GFAP, vimentin and TIMP-2 expression. The ratio of MMP-1/TIMP-2 was greater in the group with treatment then in the control group. This therapy had a trend to alleviate the fibrotic changes in pancreas.

[Evolution of surgical tactics of treatment in patients, suffering pancreonecrosis].

The experience of treatment of 121 patients, suffering an acute destructive pancreatitis, in whom various surgical interventions were conducted, was summarized. There was established, that application of miniinvasive technologies in complex with conservative therapy permits to eliminate intoxication to stabilize the patients state and to perform operation in favorable conditions.

[Application of ornigil in the perioperative prevention and therapy of infectious complications after abdominal surgery].

The experience of the drug Ornigil (infusion form ornidazole) production of "Yuria-Pharm" (Ukraine) in the treatment of the hepatopancreatobiliary zone organs diseases (acute destructive cholecystitis, pancreatitis, cholangitis, liver abscess), as well as for the prevention of purulent--septic complications after surgery for about these diseases.

[Methods of prophylaxis of an acute postoperative pancreatitis in abdominal surgery].

Experience of treatment of 105 patients, operated for the abdominal organs diseases, owing various degree of risk of an acute postoperative pancreatitis (APOP) occurrence, was summarized. Octrestatin was injected perioperatively in patients of the main group, in a control group it was not applied. Complex pancreatoprotective therapy was conducted in patients of both groups. In prophylactic application of octrestatin the trustworthy APOP occurrence frequency reduction was noted.

[Combined injury of biliary ducts and vessels during cholecystectomy: peculiarities of clinical course and surgical tactics].

The results of treatment of 56 patients, in whom in 1984-2010 yrs, while performing cholecystectomy, a biliary duct injury have occurred, were analyzed, including 26 (main group)--with combined injury of biliary ducts and brunches of common hepatic artery, 30 (control group)--with isolated complete biliary ducts. High hepaticojejunostomy have constituted the main method of operation in a control group. In the main group in 2 patients there were attempts made to restore the arterial blood flow with subsequent performance of reconstructive intervention on biliary ducts. In 16 (61.5%) patients, due to adequate collateral blood supply presence, the bile outflow was restored using hepaticojejunostomy formation, and in 8 (30.8%)--hepatic resection of various volume was needed, because of hepatic abscesses formation. The results of treatment of patients in these groups have differed not essentially, while applying differentiated approach (positive results were achieved in 93.3 and 84.6% of patients, accordingly). So, in patients with combined injury of biliary ducts and branches of hepatic artery, while performance of cholecystectomy, it is necessary to apply multimodal tactics of treatment, taking into account the peculiarities of clinical course.

[Application of Sorbilact in the treatment and prophylaxis of postoperative intestinal paresis after reconstructive operations on the biliary ducts].

The activity of complex preparation Sorbilact was studied up in the patients, suffering obturative jaundice after surgical interventions on hepatopancreatoduodenal zone organs. Preparation Sorbilact causes antishock, proenergetic, desintoxication, diuretic and procinetic intestinal effects. The Sorbilact inclusion in complex of postoperative treatment of patients secures possibility of early administration of the enteral probe nutrition, promotes the trophic state optimization as well as the rehabilitation period duration shortening.

[About expediency of terminology and classification modification for lymphadenectomy in the surgery for pancreatic cancer].

While doing pancreatic gland resection for cancer the lymphadenectomy is performed in volume, recommended on a congress of pancreatologists in Castelfranco-Venetto (standard, radical, extended radical) or in manuals of Japanese investigators (D1, D2). These classifications have got several shortages: terminological inaccuracies, lack of information, concerning the borders of the vegetative neural plexuses dissection etc. The authors have proposed a modified terminology and classification of lymphadenectomy, in accordance to which four types of lymphadenectomy are delineated: D1p, D2p, D3p, corresponding to lymphatic collectors N1, N2, N3, as well as D4p--complete excision of lymphatic nodes in all three regions while total pancreatectomy performance. The symbols 9n-dex/sin and 14n-dex/sin were recommended to name the lymph nodes of the ninth and fourteenth groups, indicating availability of the nervous plexuses dissection performance of right/left hemicircumference of vessels only. The retroperitoneal dissection borders and criterions for the lymphadenectomy volume choice were proposed.

[Efficacy of preparation metrogil in abdominal surgery].

There was summarized the experience of Metrogil (metronidazol, produced by company "Unique Pharmaceutical Laboratories", India) application for the treatment of anaerobic infection in diseases of hepatobiliary zone organs as well as for prophylaxis of purulent-septic complications in abdominal surgery.

[Modern aspects of endovideosurgical treatment of complex and recurrent inguinal hernias].

Epidemiology of complex and recurrent inguinal hernias, the stages of rising of conventional and laparoscopic hernioplasty, modern synthetic plastic materials were analyzed. The methods of transabdominal preperitoneal hernioplasty (TAPP) and extraperitoneal hernioplasty (TEP) performance are depicted. The results of laparoscopic hernioplasty, performed in 112 patients for complex and recurrent inguinal hernias in the Department of Laparoscopic Surgery and Choledocholithiasis in 1997-2009, are analyzed.

[Dekasan application in treatment of infected pancreatic necrosis and its complications].

The experience of the use of domestic antiseptic dekasan for topical use in patients over the infected pancreatic necrosis and its complications. There was significant improvement in the results of patients treatment.