[Possibilities of laparoscopic decompression of the gallbladder in middle-aged and elderly patients with diseases of the biliary tract]. / Vozmozhnosti laparoskopicheskoi dekompressii zhelchnogo puzyria u bol'nykh pozhilogo i starcheskogo vozrasta s zabolevaniiami biliarnogo trakta.

It is established that laparoscopic cholecystostomy presents the most acceptable method of gall bladder decompression in acute cholecystitis patients of advanced age comprising a high-risk group for surgery. Cholecystostomy efficiency reaches 97.2%. In case the procedure is not feasible in acute cholecystitis patients with intrahepatic position of the gall bladder or perivesicular adhesions the preference should be given to transhepatic drainage of the gall bladder whose effectiveness is 88.5%. An expedient method of laparoscopic decompression of the biliary tracts in mechanical jaundice due to tumor obstruction of the terminal part of the common bile duct is the formation of an external biliary fistula and "continuous" direct drainage of the gall bladder warranting satisfactory results in 93.3 and 100% of cases, respectively. Patients with a 1.5-week history of mechanical jaundice are not recommended transhepatic drainage, in longer duration of the jaundice (more than 1 month) it becomes contraindicated.

[The value of ultrasonic and x-ray endoscopic methods in the diagnosis of acute surgical diseases of the abdominal organs]. / Znachenie ul'trazvukovogo i rentgenoéndoskopicheskikh metodov v diagnostike ostrykh khirurgicheskikh zabolevanii organov briushnoi polosti.

The authors discuss experience in the complex use of ultrasonic and radio-endoscopic methods of examination in 820 patients who were admitted to the hospital with acute surgical diseases of the abdominal organs. Instrumental methods of diagnosis were used, which began with ultrasonic examination. The correct diagnosis of the disease was often established by this method, further examination of the patient was planned, and more concrete indications for invasive radio-endoscopic studies were determined by means of which precise data on the identified pathological process were revealed and, sometimes, adequate therapeutic measures were also ensured. Reduction of the duration of the diagnostic period to 2-3 days was the most important result of the use of these methods in the examination of patients with acute diseases of the abdominal organs.

[Receptor characteristics of the duodenal mucosa in peptic ulcer: a new approach to the individual selection of the therapy]. / Retseptornaia kharakteristika duodenal'noi slizistoi pri iazvennoi bolezni: novyi podkhod k individualizirovannomu vyboru terapii.

The radioligand-receptor method was used to assay the M-cholinereceptors and opioid binding centers in biopsy specimens of the duodenal mucosa from 40 patients with duodenal ulcer as compared with the results of subsequent therapy by means of gastrocepin (20 patients) and dalargin (20 patients). Analysis of the isothermal curve of 3H-QNB-binding with duodenal mucosa membranes within Skatchard's coordinates showed the presence of 2 subtypes of muscarinic receptors blocked (M1) and not blocked (M2) by gastrocepin. The majority of the patients in both groups demonstrated a significant decrease of the dissociation constant as compared to the control (20 patients). In patients with high receptor sensitivity to gastrocepin and dalargin, ulcer cicatrization was noted during the treatment in all the cases. Meanwhile the treatment proved little effective in patients with appreciably decreased receptor sensitivity to the drugs under consideration. The data obtained indicate the possibility of predicting the results of duodenal ulcer treatment by means of the radioreceptor analysis, providing the basis for the individualized treatment choice.