[Laboratory diagnosis of infected pancreonecrosis].

The results of treatment and examination were analyzed in 175 patients admitted to a clinic for sterile pancreonecrosis (PN). The significance of routinely available (clinical, biochemical, and microbiological) laboratory tests in the diagnosis of purulent complications was analyzed in patients with varying severity of pancreatic autolysis. Complex laboratory monitoring was found to be of importance in predicting and detecting infected PN with obligatory fine-needle punctures under ultrasound guidance and further microscopic studies of puncture specimens.

[State of the liver in patients with obesity at distant periods after formation of a "small stomach"]. / Sostoianie pecheni u bol'nykh ozhireniem v otdalennye sroki posle operatsii formirovaniia "malogo zheludka".

Histological study of biopsy specimens taken from the liver of 96 patients during operation for formation of a "small stomach" revealed fatty dystrophy of the liver in 93 patients (96.9%) which was attended by marked inflammatory and fibrous changes in 68 (70.8%) of them and by disturbed lobar structure of the liver (cirrhosis) in 2 patients (2.1%). Biochemical blood tests failed to show the pattern of the pathological changes before the operation. Study of the hepatobiliary system with methionine-75Se was the only method by which protein and pigment metabolism in the liver could be appraised. Examination of patients during 3 postoperative years showed a positive dynamics of changes in biochemical blood tests and improved protein metabolism in the hepatocytes according to the results of scanning of the liver with methionine-75Se. Thirteen repeated studies of the hepatic tissue collected from patients in different periods after operation for the formation of a "small stomach" showed a significant diminution of fatty dystrophy and inflammation of the parenchyma. The level of portal tract inflammation and portal fibrosis did not change. The findings suggest that there is an improved functional and morphological condition of the liver in weight loss caused by operation for the formation of a "small stomach", which allows this type of surgical intervention to be recommended for the treatment of patients with alimentary-constitutional obesity and initially diminished compensatory capacities of the liver.