[Treatment of obstruction of extrahepatic biliary pathways by antireflux, bilio-cholecystic (cystico) enteroanastomosis methods].

The main target of our investigations was the development of antireflux, bilio-cholecysto (cystico) enteral anastomosis method for the surgical treatment of extrahepatic biliary duct obstruction. We were using the cholecystic duct spiral valve (Lutkens valve, Haister valve) as the antireflux structure. In this case the bile drains into the biliary cyst not through the cholecystic duct but through the extrahepatic biliary duct - the bilio-cholecystic anastomosis. Such an interposition of cholecystic and spiral valves promotes inhibition of chemical reflux between extrahepatic ducts and gastrointestinal tract, from digestive tract into the cholecystic and intrahepatic biliary tracts. Method developed and tested by us involves creation of blio-cholecystic (cystico) entero anastomosis, namely creation of biliary duct-cholecystic (cystico)-duodenoanastomosis. 3 successful experimental operations have been performed using the above presented approach. Sutures were taken of on the seventh day, animals were housed under investigations for 10-14 days, faecal masses had normal appearance.

[Combined treatment of acute diffuse peritonitis]. / Kompleksnoe lechenie ostrogo rasprostranennogo peritonita.

Results of treatment in 199 patients were analysed. The patients were divided into 3 groups. In group 1 (80 patients) acute diffuse peritonitis was treated with conventional methods, in group 2 (62 patients) conventional treatment was supplemented by exchange plasmapheresis, in group 3 (57 patients) conventional treatment was used together with extracorporeal detoxication and elective relaparotomies. Plasmapheresis and elective relaparotomies resulted in increase of effectiveness of the treatment in acute diffuse peritonitis. The intervals between the elective relaparotomies and sessions of plasmapheresis depended on the stage and the course of peritonitis. Lethality rate in conventional method of treatment for acute diffuse peritonitis made up 39%, in plasmapheresis 29%, and in combined treatment--24.5%.

[Combined treatment of generalized acute peritonitis]. / Kompleznoe lechenie ostrogo razlitogo peritonita.

The results of examination and treatment of 166 patients were studied. The patients were divided into 3 groups: in the 1st (80 patients) acute generalized peritonitis was treated according to the conventional surgical canons, in the 2nd (54 patients) interchangeable plasmapheresis was added to the conventional treatment, in the 3d (32 patients) the whole complex of treatment was used--the routine method together with extracorporeal detoxication and staged sanatations of the abdominal cavity. Including plasmapheresis and staged sanatations in complex of treatment of acute generalized peritonitis intensifies the effect of treatment. The intervals between the staged sanatations and sessions of plasmapheresis depend on the stage and course of peritonitis. In the conventional method of treatment of acute generalized peritonitis according to the authors' observations the mortality rate made up 39%, when plasmapheresis was included it lowered to 30%, and when combined treatment was used mortality rate dropped to 22%. The data of this study demonstrates the potential and efficacy of combined treatment of acute generalized peritonitis with the use of interchangeable plasmapheresis and staged sanatations of the abdominal cavity.

[Gastrointestinal hemorrhages as a consequence of the side effects of drug substances]. / Zheludochno-kishechnye krovotecheniia vsledstvie pobochnogo deistviia lekarstvennykh veshchestv.

The authors observed 53 cases of profuse gastroinstestinal bleeding resulting from the use of "ulcerogenic" drugs (reserpine, prednisolone, butadione, acetylsalycylic acid) for hypertensive disease, bronchial asthma, infections polyarthritis, influenza etc. The active but temporizing therapeutic tactics was applied. Of 53 cases of profuse gastrointestinal bleeding 48 survived (90.6%) and 5 died (9.4%).

[Various indicators of water-electrolyte metabolism in ulcer and cancer of the stomach]. / Nekotorye pokazateli vodno-elektrolitnogo obmena pri iazvennoi bolezni i rake zheludka.

101 patients suffering ulcerous disease and cancer of the stomach were examined. Disorders in water-electrolyte metabolism were revealed, these being aggravated in the postoperative period, especially at the 3d--5th day following the operation. The aimed correction of the disorders concerned was made. The best results were obtained under the correction, made on the basis of absolute indices of water-electrolyte metabolism disorders.

[Treatment of diabetic gangrene]. / Lechenie diabeticheskoi gangreny

The results of treatment in 68 patients with vascular lesions of the lower limbs in diabetes mellitus are analysed. Fifty patients showed a necrotic and gangrenous stage of the disease. A grave form of diabetes was observed in half of them. In every case of diabetic angiopathy of the lower extremities vessels, irrespective of the gravity and stage of the process, insulinotherapy should be instituted. A complex therapy and preoperative management also include an adequate physiological diet, spasmolytics, vitamins, antibiotics according to an antibioticogram, and anticoagulants, local enzymotherapy, if indicated. In 13 cases spontaneous sequestration occurred, 31 patients were operated upon: sequestration--in 6, amputation--in 25. The operation was performed after elimination of auetonuria and ketonuria and reduction of hyperglycemia as low as 200 mg% (the latter was gained but not always). Recently, low amputations have been accomplished more frequently than before. No postoperative mortality was noted.