[Nonabsorbable suture material as a source of biliary calculi formation]. / Nerassasyvaiushchiisia shovnyi material kak istochnik obrazovaniia zhelchnykh kamnei.

Chemical and structural-morphological analysis of the ligature calculi in 23 patients was done. The calculi revealed were localized on silk ligatures on the 40-48th day after the operation, on the ligatures made of polyether compounds (lavsan, dagrofil)--on the 70-80th day, on polyamide ligatures (nylon, capron)--on 90-96th day. On the silk ligatures bilirubin have prevailed in the calculi structure, on the rest ligatures--cholesterol. Tactics of the patients treatment is similar to such in ordinary choledocholithiasis.

[Main principles of patient management after reconstructive and restorative surgery of extrahepatic bile ducts]. / Osnovnye printsipy vedeniia bol'nykh posle vypolneniia rekonstruktivnoi i vosstanovitel'noi operatsii na vnepechenochnykh zhelchnykh protokakh.

The basic principles of treatment of 109 patients with iatrogenic traumatization of biliary ducts are adduced. For the period of 5 years the postoperative mortality have lowered from 8.2 down to 6.8% due to the elaborated methods application, in particular the lipin administration, the apparatus for filtration application, bile sterilization and introduction in stomach, etc. In 88.3% of patients good and fair result was noted.

[Injuries of the ducts in surgery of the biliary tract]. / Povrezhdenie protokov v khirurgii zhelchnykh putei.

The authors analysed 92 reconstructive and restorative operations on the biliary tract injured at a high level during emergency operations. Such complications occur most frequently when the surgeon is insufficiently experienced or due to unavailability or incomplete use of the radiological method of intraoperative diagnostics. The expediency of reinfusion of the lost bile into the gastrointestinal tract in the diagnosis of injury to the biliary tract is pointed out. It is emphasized that patients must be transferred early to a specialized medical establishment for a reconstructive operation. The creation of hepato-digestive anastomoses on a transhepatic drain produces better results than the other drainage methods. In the group of 92 patients 77 recovered and 15 died in different periods after the operation.

[Causes and prevention of bile duct injuries during surgery]. / Prichiny i profilaktika povrezhdenii zhelchnykh protokov vo vremia vypolneniia operatsii.

From 1977 till 1993 in the clinic 108 patients were treated for the injury of extrahepatic biliary ducts occurred during cholecystectomy or gastric resection, performed mainly in the other medical departments. Injury of the ducts was diagnosed while operation performance in 68 patients. In 58 (54,6%) observations the reason of injury was the lack of surgeon's qualification and in 22 (20,3%)--nonadequate conditions of operation performance.

[The late results after rehabilitative and reconstructive operations on the bile ducts]. / Otdalennye rezul'taty posle vypolneniia vosstanovitel'nykh i rekonstruktivnykh operatsii na zhelchnykh protokakh.

Of 7000 patients operated on biliary ducts in 622 the recovering and reconstructive interventions were conducted. Late follow-up result was studied in 313 (51%) patients. Good result was noted in 179 (57.7%) patients, fair--in 99 (32.2%), poor--in 35 (10.1%) in terms from 3 months till 17 years. In patients operated on for the "forgotten" biliary ducts concrements, frequently combined with stenosis of common biliary duct terminal portion, most frequently good and fair result was noted. Late follow-up result of reconstructive operations using external transhepatic carcass drainage was significantly better than after application of other methods of correction for high stricture and injury of biliary ducts.

[Diagnosis and treatment of non-parasitic liver cyst]. / Diagnostika i lechenie neparazitarnoi kisty pecheni.

The experience with treatment of 97 patients with non-parasitary liver cysts by means of percutaneous puncture under guidance of ultrasound investigation and computed tomography has been summarized. The techniques for puncture of non-parasitary liver cysts with drainage and irrigation of a cyst cavity with the solutions of sclerosing substances are presented. The independence of a puncture method of treatment of non-parasitary liver cysts is stressed. A high effectiveness of the method is emphasized.

[The surgical correction of iatrogenic damage to and cicatricial stricture of the extrahepatic bile ducts]. / Khirurgicheskaia korrektsiia iatrogennogo povrezhdeniia i rubtsovoi striktury vnepechenochnykh zhelchnykh protokov.

In treatment of 86 patients with a iatrogenic injury, or cicatricial stricture of the extrahepatic bile ducts, the Prader-Smith, Saypole-Kurian transhepatic drainage of hepatico-digestive anastomosis and that with the use of the method suggested by the authors have been used. The technique for performance of the operations is described, the special instruments are offered. After the operation, only one female patient has developed a subphrenic abscess.

[Methods of designing a prognostic system, regression models and risk scale in the surgical treatment of cholelithiasis]. / Metodika postroeniia prognosticheskoi sistemy, regressionnykh modelei i shkaly riska v khirurgichedskom lechenii zhelchnokamennoi bolezni.

An automated assessment of the results of treatment and prediction of a course of the postoperative period was performed in 218 patients with cholelithiasis by means of ES computer according to 100 parameters. Five statistic packs of the application programs (VMDR-75 version) were used. Cluster-analysis, factor analysis and a method of the main components were employed. Four most essential risk factors were distinguished, the regressive models of a postoperative period obtained. This permitted to choose the most rational method for treatment.

[Errors in the diagnosis and treatment of acute appendicitis]. / Oshibki v diagnostike i lechenii ostrogo appenditsita.

On the basis of an analysis of 17824 patients with acute appendicitis the authors make a conclusion that the main cause of neglected forms of acute appendicitis is late consultations of the patients and diagnostic and tactical errors of physicians mainly in the prehospital period. Most of the errors in the treatment of the disease result from a wrong assessment of spread of the process, technical difficulties during operations, inadequate operative access and drainage of the abdominal cavity, unreliable treatment of the process stump and its mesenterium.