ABSTRACT
The aim of this work was to estimate hepatic dysfunction and improve treatment of benign mechanical jaundice using an injection hepatoprotector. The study included 124 patients of whom 74 were given remaxol. 50 control subjects received basal therapy. The patients were randomized by the random sampling method. Severity of cholestasis was evaluated from the total and fractional bilirubin content and γ-glutamyl transpeptidase (GGT) level; AST and ALT activities were used to detect cytolysis. Liver synthetic function was estimated from prothrombin index (PTI) and coagulation function from fibrinogen level, PTI and APTT. Endogenous intoxication during biliary tract decompression was assessed by calculating the leukocyte intoxication index from the Kalf-Kalif formula. It was shown that remaxol suppresses cytolysis, reduces total and fractional bilirubin levels, improves bilirubin excretion in bile and decreases activity of hepatocyte excretory enzymes.
Subject(s)
Hepatic Insufficiency/drug therapy , Jaundice, Obstructive/drug therapy , Preoperative Period , Succinates/pharmacology , Adult , Humans , Succinates/administration & dosage , Treatment OutcomeSubject(s)
Appendectomy , Appendicitis , Laparoscopy/methods , Minimally Invasive Surgical Procedures/methods , Natural Orifice Endoscopic Surgery/methods , Postoperative Complications , Appendectomy/history , Appendectomy/methods , Appendicitis/complications , Appendicitis/surgery , History, 20th Century , Humans , Laparoscopy/adverse effects , Minimally Invasive Surgical Procedures/adverse effects , Natural Orifice Endoscopic Surgery/adverse effects , Outcome and Process Assessment, Health Care , Postoperative Complications/epidemiology , Postoperative Complications/prevention & control , Randomized Controlled Trials as TopicSubject(s)
Jaundice, Obstructive , Liver Failure , Postoperative Complications , Succinates , Aged , Cholelithiasis/complications , Decompression, Surgical/adverse effects , Decompression, Surgical/methods , Drug Combinations , Drug Monitoring , Female , Humans , Infusions, Intravenous , Jaundice, Obstructive/etiology , Jaundice, Obstructive/metabolism , Jaundice, Obstructive/surgery , Liver Failure/drug therapy , Liver Failure/etiology , Liver Failure/metabolism , Liver Function Tests/methods , Male , Middle Aged , Perioperative Care/methods , Postoperative Complications/drug therapy , Postoperative Complications/metabolism , Protective Agents/administration & dosage , Protective Agents/pharmacokinetics , Succinates/administration & dosage , Succinates/pharmacokinetics , Treatment OutcomeABSTRACT
Treatment results of 101 patients, operated on with the diagnosis of the chronic appendicitis, were analyzed. Of them, 55 had periodic right iliac pain syndrome, the rest 46 had a history of appendicular abscess or infiltrate. 58 patients were operated on laparoscopically, the rest had traditional open appendectomy. The use of ultrasound and roentgen diagnostics proved to be non-effective. The reliable laparoscopic symptoms of chronic appendicitis were singled out. The laparoscopy provided the correct diagnosis in 93.3% of patients and allowed avoiding the groundless appendectomy in 31.2%. The intraoperative ultrasound is helpful in questionable cases. The diagnostic and treatment algorithm for chronic appendicitis, based on laparoscopic methods, was worked out.
Subject(s)
Abdominal Pain , Appendectomy , Appendicitis , Intraoperative Care/methods , Laparoscopy/standards , Postoperative Complications/prevention & control , Abdominal Pain/etiology , Abdominal Pain/physiopathology , Abdominal Pain/surgery , Adolescent , Adult , Appendectomy/methods , Appendectomy/standards , Appendicitis/complications , Appendicitis/pathology , Appendicitis/physiopathology , Appendicitis/surgery , Appendix/diagnostic imaging , Appendix/pathology , Appendix/surgery , Chronic Disease , Diagnosis, Differential , Female , Humans , Intraoperative Care/standards , Male , Middle Aged , Treatment Outcome , UltrasonographyABSTRACT
915 diagnostic laparoscopies for the suspicion on the acute appendicitis were analyzed. Frequency of the acute surgical disease' absence in patients with right iliac pain was defined. The frequency of the chronic appendicitis was defined, basing on the morphologic investigation of the 321 resected appendixes, ectomized on the reason of the acute appendicitis. Literature and personal experience were reviewed to set the frequency of the recurrence secondary chronic appendicitis. Clinical and morphological correlations between chronic noninflammation changes of the appendix and right iliac pain were followed.