[THE TREATMENT OF POSTOPERATIVE STRICTURE OF BILIARY DUCTS: A 15-YEARS EXPERIENCE AND OBSERVATIONS FROM THE PRACTICE].

Experience of performance of 160 operations for injuries and stricture of biliary ducts, was analyzed. In 36 patients before admittance to hospital there were performed interventions, which provide correction of injuries or their consequences. In majority (141) of patients hepaticojejunoanastomosis in accordance to Roux method or its reconstruction were performed. Other interventions (right-sided hemihepatectomy) were rarely performed. The procedure of anastomosis formation, permitting to connect the mucosae of joining organs in precision, was proposed. Clinical observations of correction of the biliary ducts stricture were presented.

[Surgical treatment of a solitary hepatic abscess].

Retrospective analysis of the treatment results of 120 patients, suffering solitary hepatic abscess (SHA), was conducted. The sanation methods, in accordance to technology, the treatment impact intensity and aggressiveness, may be divided on three lines: aspirational, draining and resectional. The method of sanation is selected on the background of morphological peculiarities of abscess--its sizes, by presence of sequesters, divisioning septs, dense rigid capsule, grade of periprocess. Surgical access is determined by the abscess localization, the patient's state severity, instrumental equipment of the clinic. Differentiated approach, taking into account genesis, sizes, localization and stage of its formation, constitutes a background of successful treatment of SHA. In totally formatted acute SHA, as a rule, the methods of choice are aspirational and aspiration-draining methods of sanation under ultrasonographic control or laparoscopy. In the presence of chronic SHA or suppurated parasitic hepatic cyst it is mandatory to select the resectional methods.

[Application of mini-invasive technologies in the treatment of gastrointestinal bezoars].

The data on etiology, clinical signs, diagnosis and variety of approaches to the treatment of gastrointestinal bezoars were presented, basing on the worldwide literature analysis. The results of surgical treatment of patients for bezoars, using miniinvasive methods, are presented.

[Curative-tactical approaches in patients with pancreatic pseudocyst]. / Lechebno-takticheskie podkhody u bol'nykh s psevdokistoi podzheludochnoi zhelezy.

Experience of treatment in the clinic of 162 patients with pancreatic pseudocyst was analyzed. Modern principles of diagnosis and treatment of patients were adduced. Operation before the cyst capsule formation is compulsory, caused by the complications occurrence and the pancreonecrosis progression. External drainage of an acute pancreatic pseudocyst was performed in 61 patients, internal drainage--in 72. After external drainage the cyst recurrence was noted in 17, the pancreatic fistula formation--in 7 patients. The poorest results were noted in patients with infected pancreonecrosis and in pseudocyst formation.

[Strategies and techniques in the correction of the enteral insufficiency in peritonitis and acute ileus]. / Taktika i tekhnika korrektsii énteral'noi nedostatochnosti pri peritonite i ostroi neprokhodimosti kishechnika.

The correction principles of enteral insufficiency, playing essential role in the infectional-toxical shock and polyorganic insufficiency occurrence were elaborated basing on the analyses of the surgical treatment of 257 patients with peritonitis and an acute ileus. Application of the proposed tactics of surgical aid for patients, including the original methods of the gut intubation, had permitted to lower the lethality from 30.2 to 18.5%, to improve the treatment results.

[The role of the intestines in the pathogenesis of acute pancreatitis: oxygen extraction and bacteria translocation in rats]. / Rol' kishechnika v patogeneze ostrogo pankreatita: ékstraktsiia kisloroda i translokatsiia bakterii u krys.

In experiment on 40 male rats of the Wistar line there was investigated the oxygen extraction (O2) and the bacteria translocation in 30 min, 2, 6, 12 and 24 hours after the stimulating operation (control group) and simulation of the ductal-hypertensive form of an acute experimental pancreatitis (AEP)--the main group. The data obtained witness the general extraction of O2 raising by 222% (P < 0.001) at average and lowering of its intestinal extraction in 30 min and 2 hours (by 33 and 31% at average, P < 0.05) and its raising in 24 hours by 138% (P < 0.001) at average also. These disorders had correlated with velocity of the intestinal E. coli reproduction and with the bacteria translocation on the way intestine-->mesenterial lymph nodes in 6 hours after the disease occurrence with preservation of the lymph nodes and the liver barrier function in the AEP duration over 24 hours. The data obtained had permitted to substantiate the necessity of the remedial measures complex application, directed on the frequency of purulent complications lowering.

[The surgical risk factors in the use of laparoscopic cholecystectomy]. / Faktory khirurgicheskogo riska pri primenenii laparoskopicheskoi kholetsistéktomii.

The increased risk factors--gender, age of the patient, the cholelithic disease existence duration, the acuteness of inflammation, the operations performed earlier on the abdominal cavity organs, influencing the laparoscopic cholecystectomy conduction for Courvoisier's gallbladder--were analyzed. The increase of intraoperative complications occurrence (hemorrhage, perforation of gallbladder, the outhepatic biliary ducts) in patients of elder age with durable disease was noted.