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Moreover, this approach is valuable to localize the foci of pancreatic necrosis in 79% of cases. the An efficiency of endoscopic decompression of the main pancreatic duct was 42% in patients with alcoholic pancreatitis.
Endoscopic stenting of the main pancreatic duct is effective for pathogenetic treatment of patients with biliary pancreatitis, aimed at reducing intraductal hypertension in the early stages of disease.
Endoscopic stenting of the main pancreatic duct is effective for pathogenetic treatment of patients with biliary pancreatitis, aimed at reducing intraductal hypertension in the early stages of disease.
To improve the treatment outcomes in patients with primary and metastatic liver tumors localized in segments VII-VIII involving the right hepatic vein and its branches.
There were 16 surgical interventions including resection of liver segment VII and/or VIII with resection of the right hepatic vein and its branches without reconstruction. All procedures were carried out at the Department of Liver and Pancreatic Tumors of the Blokhin National Medical Cancer Research Center for the period 2016-2020. The cause of surgery was colorectal cancer liver metastases in 8 patients, hepatocellular carcinoma in 2 cases, angiomyolipoma in 1 case and metastases of uterine cancer in 1 patient. Minor liver resection was additionally performed in 5 cases.
Median surgery time was 150 (80-220) min, intraoperative blood loss - 400 (100-2000) ml. Afferent blood flow was blocked in 4 patients for 14 (12-25) min. None patient had intraoperative signs of impaired venous outflow. Biliary fistula in postoperative period occurred in 1 patient. No complications were noted in other cases. Median postoperative hospital-stay was 13 (9-19) days. this website There were no specific complications in long-term postoperative period that could be associated with venous outflow blockade through the right hepatic vein.
Existing vessels and intrahepatic collaterals de novo can provide adequate venous outflow into the middle hepatic vein and short hepatic veins during resection of liver segments VII and/or VIII with resection of the right hepatic vein and its branches without reconstruction and the absence of inferior right hepatic vein.
Existing vessels and intrahepatic collaterals de novo can provide adequate venous outflow into the middle hepatic vein and short hepatic veins during resection of liver segments VII and/or VIII with resection of the right hepatic vein and its branches without reconstruction and the absence of inferior right hepatic vein.
To determine the main trigger mechanisms of multiple organ failure in acute severe pancreatitis.
An experimental study included 26 dogs with pancreatic necrosis. We assessed homeostasis disorders and functional changes in the pancreas, bowel, liver, kidneys, lungs and heart. Forty-six patients with severe acute pancreatitis were examined. We studied homeostasis disorders and functional state of the organs, endotoxemia, lipid peroxidation, phospholipase activity, coagulation system and hypoxia.
Injury of various organs and systems due to systemic inflammatory response at the early stage of disease is an important aspect in progression of acute pancreatitis. Membrane destabilizing phenomena and disturbances in tissue component of coagulation system are the most significant factors. Patients with severe acute pancreatitis had significant changes in homeostasis. We distinguished two subgroups of patients. The course of disease was different. In the first subgroup, changes in homeostatic parameters were 15.4rs for a cascade of the same kind of pathophysiological phenomena contributing to multiple organ failure and pancreatitis. In the tissues of various organs, proportional growth of these markers is observed until the 6th day, while in the blood - until the 4th day.
To evaluate the effectiveness and postoperative morbidity after endarterectomy from the iliac arteries in comparison with ilio-femoral and aorto-femoral replacement in patients with chronic critical lower limb ischemia.
There were 95 patients with chronic critical lower limb ischemia. Iliac artery replacement was carried out in 43 (45.3%) patients, endarterectomy from the iliac arteries - in 52 (54.7%) cases. Trophic disorders on the lower extremities occurred in 36 (37.9%) patients.
Iliac artery replacement was accompanied by postoperative wound suppuration and infection of prosthesis in 3 (6.9%) patients, postoperative ventral hernia in 2 (4.7%) patients. The total number of complications specific for endarterectomy (iliac artery perforation - 1 (1.9%) patient, iliac artery thrombosis - 3 (5.8%) patients) was similar to the literature data. Successful endarterectomy was performed in 52 (88.1%) patients. Iliac segment patency was similar in both groups throughout a 12-month follow-up period.
Endarterectomy from the iliac arteries has some advantages over replacement and should be preferred for trophic complications on the lower extremities.
Endarterectomy from the iliac arteries has some advantages over replacement and should be preferred for trophic complications on the lower extremities.
To develop the algorithm for correction of defects following high-voltage electrical trauma with revascularized autografts, to assess the incidence and risk factors of postoperative complications.
Surgical interventions were performed in 16 men. Autografts were selected considering localization of defect and preoperative ultrasound data on perfusion of donor and recipient areas. We applied a sample with temporary compression of the vessels and ultrasound scanning of arteries and veins (a small-sized Doppler sound indicator of blood flow velocity - MINIDOP, BIOSS).
Nine patients underwent microsurgical transplantation of revascularized flaps. Six patients with electrical trauma of the upper extremities underwent transplantation of free skin autografts and transposition of flexor and extensor muscles of the fingers in various combinations. In 1 patient, simultaneous microsurgical graft transplantation and plasty with local tissues were carried out. Microsurgical transplantation of thoracodorsal flap was performed in 2 patients with maxillofacial defect (with preliminary deepidermization of the flap in one case).
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