[Resection of the esophagus and gastric cardia in portal hypertension in light of the late results].

Having studied the experience of 84 resections of the oesophagus and gastric cardia in patients with portal hypertension and taking into account postoperative complications (reflux-oesophagitis, progressing loss of weight, dispeptic disorders, phenomena of agastric asthenia etc.) the authors came to a conclusion that the indications for this surgical intervention should be lessened and recommended the indication to be justified only as the last attempt of the surgeon in his struggle against recurrent hemorrhage from varicose veins of the oesophagus which should be preceded with transthoracic oesophago- or gastrotomy with the ligation of varicose veins.

[Mechanical jaundice in extrahepatic portal hypertension].

The authors consider the tactics of the treatment of mechanical jaundice in 9 patients suffering from an extrahepatic form of portal hypertension. The analysis of the results of the treatment proved that in case of pronounced bilirubinemia with colangitis manifestations and hepatic insufficiency it is indicated to use external controlled drainage of the thoracic lymphatic duct and transhepatic external drainage of the intrahepatic duct. The applied tactics allows to avoid carrying out emergent surgical interventions on extrahepatic bile passages, which is extremely dangerous, and to perform such operations when necessary only, under more favourable conditions after an adequate preparation of patients.

[Controlled drainage of the thoracic duct (author's transl)].

The technique of the thoracic duct drainage is described. The importance of preserving the natural lymph outflow is emphasized. A method of controlled thoracic duct drainage is introduced that permits dosaged exteriorization of the lymph and additional internal drainage of the lymph into the veins via an external bypass for a long period of time.