[Laparoscopic surgery in adhesive disease]. / Laparoskopicheskie operatsii pri spaechnoi bolezni.

Experience in 2277 laparoscopic surgeries performed in patients with history of conventional and minimally invasive surgeries is analyzed. Regularities of commissures formation after some surgeries are determined. Viscero-parietal commissures (VPC) which are the main cause of possible intraoperative complications were revealed in 1746 (76,7%) patients. Diagnostic value of special ultrasonic examination was 95,5%, on the average. Laparoscopic adhesiolysis in different types of adhesive disease was attempted in 195 patients, 170 (87,2%) procedures were finished successfully. Application of Interceed (TC-7) on parietal peritoneum was used in 14 patients to prevent repeated formation of commissures.

[Errors in ultrasonic diagnosis of abdominal diseases]. / Oshibki ul'trazvukovoi diagnostiki zabolevanii organov briushnoi polosti.

Errors in the ultrasonic diagnosis of diseases of the abdominal organs in 2,218 patients were analysed in comparison to endoscopic and operative findings. The errors were few in number. A precise diagnosis was established in 99.6% of cases with acute cholecystitis and in 78% of those with a pathological process in the biliary tract. A maximum number of errors (7 per 42 cases) was encountered in carcinoma of the gallbladder. Ultrasonic examination may serve as the basis for choosing the method of rational therapy in diseases of the liver, pancreas, and complications in the postoperative period. Thus, the results of ultrasonic examination may be fully relied on or may be used as a basis for choosing manipulations which are more invasive in character.

[Ultrasonic semeiotics and diagnosis of acute cholecystitis]. / Ul'trazvukovaia semiotika i diagnostika ostrogo kholetsistita.

From analysis of the results of ultrasonic examination in 1,428 patients with acute cholecystitis the authors determined the semeiotics of various forms and complications of the disease. The most common ultrasonic sign of acute cholecystitis is a triad of symptoms: enlarged gallbladder, thickened walls, and fixed hyperchostructures with an acoustic shadow in the projection of the neck of the gallbladder. Ultrasonic examination allows the presence of destructive cholecystitis to be detected with high precision on basis of the sign of a double gallbladder contour. Complications like pericystic infiltration, pericystic abscess with or without perforation, empyema of the gallbladder, acute pancreatitis, and choledocholithiasis can also be recognized in patients with acute cholecystitis by ultrasonic examination. Comparison of the data of ultrasonic examination with those obtained in laparoscopy or operation showed that the diagnosis coincided in 98.9% of cases.