[Laparoscopic cholecystectomy in patients with liver cirrhosis]. / Laparoskopicheskaya kholetsistektomiya u bol'nykh tsirrozom pecheni.

AIM: To assess efficacy and safety of laparoscopic cholecystectomy in patients with liver cirrhosis. MATERIAL AND METHODS: 46 patients with liver cirrhosis Child-Pugh class A and B underwent laparoscopic cholecystectomy for the period from August 2001 to December 2015. Indications for surgery were acute calculous cholecystitis in 21 (45.6%) patients and chronic calculous cholecystitis in 25 (54.4%) patients. RESULTS: Mean surgery time was 75 minutes. Conversion to open surgery was required in 2 patients. Postoperative complications including bleeding, liver dysfunction, ascites, wound complications were observed in 11 (23.9%) patients. There were no deaths. Mean hospital-stay time was 2.5 days. CONCLUSION: Laparoscopic cholecystectomy may be successfully performed in carefully selected patients with compensated cirrhosis. The advantages of minimally invasive technique are less blood loss, surgery time and hospital-stay.

[Ultrasound examination for diagnosis of postoperative peritonitis]. / Ul'trazvukovoe issledovanie v diagnostike polseoperatsionnogo peritonita.

78 patients with peritonitis after various operations on the organs of abdominal cavity were followed up. Ultrasound examinations (n = 86) were carried out in 59 patients. In 28 of them US has revealed abscesses of the abdominal cavity. Comparative analysis showed coincidence of the diagnosis of peritonitis by clinical and roentgenological data with the results of relaparotomy in 10 (58.8%) of 17 examined patients. The same coincidence of the diagnosis of peritonitis by clinical, roentgenological and sonographic data on one side and of the results of relaparotomy on the other was found in 48 (81.4%) of 59 patients with peritonitis. It is stated, that US examination considerably increases the effectiveness of the diagnosis of postoperative peritonitis and incapsulated cavities.

[Immunologic reactivity of patients with obstructive jaundice of non-neoplastic etiology]. / Immunoreaktivnos't u bo'lnykh s mekhanicheskoi zheltukhoi neopukholevogo geneza.

Immunity values were studied in patients with obstructive jaundice of cholelithic etiology. The number of immune cells was reduced and the formation of antibodies was deficient in these patients in the preoperative period. The degree of immunodeficiency correlated with the duration of jaundice and the degree of bilirubinemia. The level of autoantigens was also increased. An operation promotes still greater suppression of immunity. The values of immunity were normalized earlier in patients who had received immunomodulation therapy.

[Possibilities of ultrasonic examination in mechanical jaundice]. / Vozmozhnosti u'ltrazvukovogo issledovaniia pri mekhanicheskoi zheltukhe.

Under analysis were results of ultrasonic examination of 280 patients with mechanical jaundice. In 137 of them the echotomographic diagnoses were verified by findings of other methods of examination of bile ducts and operative procedures. The origin of jaundice was exactly determined in 95.7% of the patients with the help of ultrasonic examination. The cause of mechanical jaundice was correctly established in 76% of the patients. In 66.6% of the patients operated upon the surgical tactics was determined by results of echotomography only.

[Diagnosis and treatment of acute cholangitis]. / Diagnostika i lechenie ostrogo kholangita.

The results of surgical treatment of 114 patients with acute cholangitis were analysed. With the aim of early diagnosis, the sonography and direct contrasting of the bile ducts were used. The conservative treatment has proved to be effective in 64.9%. Bile ducts decompression before the operation was performed in 29 patients, its effectiveness was 89.6%. Overall lethality in acute cholangitis was 11.4%.

[Percutaneous transhepatic cholangiostomy in malignant tumors of the proximal sections of the extrahepatic bile ducts]. / Chreskozhnaia chrespechenochnaia kholangiostomiia pri zlokachestvennykh opukholiakh proksimal'nykh otdelov vnepechenochnykh zhelchnykh protokov.

The results of the use of percutaneous transhepatic cholangiostomy (PTCS) in 21 patient with obstructive jaundice, caused by tumour obstruction of the proximal bile ducts were studied. PTCS in 15 patients was a definitive intervention, which adequately substituted palliative bile-diverting operations, and in 6--served as an effective method of preoperative preparation. In 3 patients, the PTCS was used for combined internal-external bile diversion.