[Diagnosis and surgical treatment of cavernous hemangioma of the liver]. / Diagnostika i khirurgicheskoe lechenie kavernoznykh gemangiom pecheni.

Results of surgical treatment of cavernous liner hemangiomas in 47 patients have been analysed. In 7 cases the original method of surgery in unresectable liver hemangiomas was used. The method was designed by the authors of the article. The proper diagnosis of liver hemangiomas is possible in the specialized divisions only. Ultrasound examination, CT and laparoscopy play the major role in diagnosis. Anatomical liver resection is the major surgical method. In cases of unresectable hemangiomas the method of omento-hepatopexy with subsequent X-ray therapy is indicated.

[Treatment of mediastinitis]. / Lechenie mediastinita.

The authors work is based on experience in the study of 56 patients with acute mediastinitis of various origin who were treated in the period from 1981 to 1990. There were 33 males and 23 females whose ages ranged from 16 to 65 years, Odontogenous mediastinitis was diagnosed in 23, tonsillogenous in 2, and mediastinitis resulting from injury to the esophagus in 31 patients. Instrumental injuries prevailed. All patients underwent operation. The character of the operation was determined by the duration, localization, and severity of the pyonecrotic process in the mediastinum. Diffuse anterior mediastinitis was managed by tunneling and drainage of the mediastinum through the seat of the removed xiphoid process. Prophylactic treatment of the mediastinal space and intensive therapy including active detoxification were applied in the 56 patients who underwent operation died, 26 of them were admitted to the clinic 24-72 hours after the onset of the disease in a state of severe intoxication caused by violently developing mediastinitis. The remaining 27 patients recovered.

[The diagnostic and treatment characteristics of focal liver lesions using computed tomography]. / Osobennosti diagnostiki i lecheniia ochagovykh porazhenii pecheni s ispol'zovaniem komp'iuternoi tomografii.

Under analysis is an experience with examining and treatment of 167 patients with focal lesions of the liver using computed tomography. Percutaneous transhepatic puncture and draining the hepatic abscesses and cysts under control of computed tomography is an independent method of treatment used in 53 patients. The technique of performing the puncture and drainage is described. Specific features of surgical treatment of focal lesions of the liver are described. Decompression of bile ducts in the postoperative period is shown to be necessary. A conclusion is made about high efficiency of computed tomography in diagnosis and treatment of focal lesions of the liver.

[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.

[Methods for the prevention and treatment of acholia]. / Sposoby profilaktiki i lecheniia akholicheskoi bolezni.

In the clinic, the special appliances and apparatus for collection of the bile, its filtration, sterilization and introduction into the stomach of a patient were developed and used in patients with external biliary fistula. Since 1987, the original method for treatment of the alcoholic disease has been introduced. It was used in 40 patients.

[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.

[Computer prognostication in surgery of choledocholithiasis]. / Komp'iuternoe prognozirovanie v khirurgii kholedokholitiaza.

The automatized value of treatment results and postoperative period course was done according to special programs in 218 patients with choledocholithiasis using the united computer system. Integral risk factors and four regressional patterns of postoperative period course were obtained using the factor analysis. Prognosis was quite right in 87,5-97,5% of patients.

[Recurrent pulmonary hemorrhage]. / Retsidiviruiushchee legochnoe krovotechenie.

The results of treatment of 235 patients with pulmonary hemorrhage of various etiology which stayed in clinic in 1980-1992 yrs. were analyzed. Of 216 patients, whom diagnostic bronchoscopy was performed, the hemorrhage origin was found in 137, of whom in 13 its localization was imprecise. Seventeen patients have died, of whom 11--before operative intervention was done. The method of temporary occlusion of presumably bleeding lobar or segmental bronchus with the help of obturator containing the leaded out transnasally catheter was proposed to localize precisely the pulmonary hemorrhage origin. The hemorrhage origin localization is confirmed by subsequent appearance of blood from the external end of catheter.

[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.

[The importance of ultrasonic and morphological studies in the differential diagnosis of tumor, dyshormonal and inflammatory diseases of the breast]. / Znachenie ul'trazvukovogo i morfologicheskogo issledovanii v differentsial'noi diagnostike opukholevykh, disgormonal'nykh i vospalitel'nykh zabolevanii molochnoi zhelezy.

The ultrasonic examination results of mammary gland and regional lymph outflow zones were studied in 16,542 patients, including 415 with punction biopsy performance. The mammary gland cancer diagnosis was verified at the cytological examination of bioptic materials in 108 patients.

[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.

[Surgical treatment of patients with cholestatic hepatitis]. / Khirurgicheskoe lechenie bolnykh s kholestaticheskoi formoi gepatita.

The experience with treatment of 86 patients with cholestatic form of hepatitis has been summarized. The operative intervention included drainage of the extrahepatic bile ducts, denervation of the hepatoduodenal ligament, marginal hepatic resection. In ineffective conservative therapy, the patients should be operated on at the early period. When establishing the indications for the operation, the functional state of hepatocytes should be considered.

[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.