[Emergency laparoscopy in the treatment of perforated gastroduodenal ulcers]. / Ekstrennaya laparoskopiya pri lechenii perforativnykh gastroduodenal'nykh yazv.

OBJECTIVE: To compare the results of endoscopic and open treatment of perforated gastroduodenal ulcers. MATERIAL AND METHODS: There were 445 patients with perforated gastroduodenal ulcers between 2013 and 2021. Endoscopic suturing of perforation was performed in 172 patients (38.7%), 273 ones underwent open surgery. RESULTS: Among 172 patients scheduled for endoscopy, 160 (93.6%) ones underwent laparoscopic suturing of perforation. Morbidity rate was 5.0% (n=8), postoperative mortality rate - 1.3% (n=2). Comparison of the outcomes after laparoscopic suturing of ulcers in 160 patients and open surgery in 134 patients showed that laparoscopy was followed by 2.5 times lower incidence of complications and 3 times lower postoperative mortality. CONCLUSION: Diagnostic laparoscopy is advisable in patients with perforated ulcers and no contraindications. In most cases, surgery can be successfully and effectively completed without conversion to laparotomy. Endoscopic closure of ulcerative defect is preferable since this procedure has certain advantages over traditional intervention, contributes to significant reduction in morbidity, mortality and hospital-stay.

Rotational Brownian motion of axisymmetric particles in a Maxwell fluid.

A theory of non-Markovian rotational Brownian motion is developed for axisymmetric particles moving in a Maxwell fluid in the presence of an external field. Both the inertial and viscoelastic effects are taken into account. A kinetic equation for the joint probability distribution of orientation, angular velocity, and acceleration of a particle without spin is derived starting from the rotational Langevin equation with relaxed hydrodynamic and random torques. A third-order stochastic differential equation for the particle orientation vector is also derived. Directly from this equation, the set of nonlinear evolution equations for one-time moments is derived in a noninertial approximation. The expressions for a linear response to a time-dependent external field and dynamic susceptibility of particle are obtained by direct averaging of particle orientation equation. Appendices derive the rotational mobility of axisymmetric particles in a general linear viscoelastic fluid, and the evolution equations for one-time moments of the orientation vector for axisymmetric particles moving in a Maxwell fluid in the presence of an external field.