[Modern tendencies in surgical treatment of patients with obturation jaundice complicated by hepatic insufficiency].

The article is devoted to the problem of efficacy of the hepatic insufficiency (HI) prophylaxis and treatment methods in obturation jaundice. The role of energy-depending processes and the oxygen deficiency in tissues in the HI occurrence and progressing, the possibilities of medicinal correction of such disorders were studied up. The authors follow the concept of expediency of the oxygen-bearing preparations, which improve the erythrocytes function and oxygen delivery to the tissues in combination with miniinvasive decompression of bilioefferent ways, incorporation into the treatment complex of HI of mechanic genesis.

[Estimation of efficacy of the correction methods for hepatic functional disorders in cholestasis of mechanical nature].

Efficacy of the prophylaxis and treatment methods for hepatic insufficiency in obstructive jaundice was studied. The role of an energy-dependent processes and the tissue deficit of oxygen in the hepatic insufficiency occurrence and progress, possibility of these disorders medicinal correction was delineated. The expediency of introduction of preparations, improving the erythrocytes function and the oxygen delivery to tissues in conjunction with miniinvasive biliary decompression, in therapeutic complex for hepatic insufficiency of mechanical nature was noted.

[Versions of the bile outflow restoration in reconstructive and restorative surgery on the bile duct]. / Varianty vosstanovleniia zhelcheottoka pri vypolnenii rekontruktinynoi i vosstanovitel'noi operatsii na zhelchnykh protokakh.

The results of performance of 90 restoration and reconstructive operations in 71 patients with iatrogenic injury of extrahepatic biliary ducts were analyzed. The risk factors of iatrogenic injury were delineated. Original methods of restoration of the bile outflow into intestine were offered. The method of external extraperitoneal cholangiostomy via hepatic round ligament was recommended. Total postoperative mortality had constituted 15.7%.

[Diagnosis and treatment of closed injury of liver]. / Diagnostika i lechenie zakrytogo povrezhdeniia pecheni.

The experience of surgical treatment of closed injury of liver (CIL) in 101 patients is summarized. The complex scheme of therapeutic and diagnostical measures in patients with CIL was elaborated. This included diagnostic algorithm that allows to diagnose the injury in time, intra-operation tactical measures, directing of post-operation period. Application of this scheme in 26 patients with CIL permitted to decrease post-operative complications rate by 5.9%, mortality--by 10.1%.

[Influence of ozone on biochemical and cytochemical indexes of the blood in early period after experimental hepatic trauma]. / Vliianie ozona na biokhimicheskie i tsitokhimicheskie pokazateli krovi v rannem periode posle éksperimental'noi travmy pecheni.

The influence of isotonic solution of ozonized chloride sodium (OISCHS) on the peroxide oxidation of lipids (POL) intensity, the antioxidant system (AOS) and aminotranspherase enzymes activity, the middle molecular mass peptides (MMMP) concentration in the blood serum and activity of dehydrogenase in neutrophils of peripheral blood in 1, 3, 6, 9 hours after modelling of mechanical dosaged hepatic trauma was studied in experiment on 20 dogs (principal group). OISCHS was infused intravenously by dropper, the ozone concentration was 1.3-1.5 mg/l. Essential bioregulating effect of ozone brought to the system POL/AOS balance normalization, surveying the aminotranspherases and dehydrogenases, activization, stable lowering of MMMP concentration.

[The dynamics of the tissue blood flow changes of the oxygen pressure and of the vessels reactivity in non-damaged hepatic tissue in mechanical trauma]. / Dinamika izmenenii tkanevogo krovotoka, napriazheniia kisloroda i reaktivnosti sosudov v nepovrezhdennoi tkani pecheni pri ee mekhanicheskoi travme.

The mechanical hepatic trauma was simulated in experiment on dogs. Long local blood flow reduction, the oxygen pressure lowering in nonaffected hepatic tissue and organic blood flow in kidney as well were noted while the 34.2% hepatic mass injury with 10.58% blood loss. The magnitude of the vessels reactivity coefficient of these organs is reducing in 30 min and 1 hour after the hepatic injury occurrence and then changes in untrustworthy manner.