[Comparative study of the use of mivacron and tracrium in anesthesia during laparoscopic cholecystectomy].

Two nondepolarizing myorelaxants: tracrium, with medium-long duration of action, and a new short-acting drug mivacron were used in combined anesthesia of 50 patients with gastrointestinal diseases subjected to laparoscopic cholecystectomy. Both drugs can be used for anesthesia of laparoscopic operations; mivacron should be preferred due to its shorter action.

[Surgical tactics in cholangitis in middle-aged and elderly patients].

The authors analysed the results of examination and treatment of 399 elderly and old-aged patients in the period between 1971 and 1981. At that time cholangitis was managed in 146 (36.6%) patients mainly by surgical intracavitary operations, in 21.

[Recurrent and residual stones in the bile ducts].

Data of 205 patients with recurrent (48) and residual (157) choledocholithiases are presented. In most observations postoperative cholelithiasis proceeded by the type of chronic intermittent obturation of bile ducts. Highly effective method of diagnosing recurrent and residual calculi is thought to be the endoscopic retrograde pancreatocholangiography, best results of the treatment being obtained after the endoscopic papillosphincterotomy which should be used as the operation of choice.

[Evaluation of late results of surgical treatment of choledocho- lithiasis].

An experience with repeated examinations of 656 patients operated upon for bile calculi is presented. It was shown that the estimation of long-term results of surgical treatment of choledocholithiasis should be performed on the basis of common criteria three years after operation by complex use of clinical, laboratory, X-ray and endoscopic methods of examination. Debatable questions associated with the interpretation of special examinations and their influence on the clinical estimation of long-term results are elucidated.

[Late results of the surgical treatment of patients with biliary calculi].

The authors analyse the late results of surgical treatment of 463 patients who underwent operation for stones in the bile ducts. The late results were found to be determined by the character of the affection of the bile excreting system and the rational choice of the operative method. The indications and contraindications for various methods of treating cholelithiasis were determined more precisely from study of the late results.

[Treatment of nontumorous obstructive jaundice and cholangitis in middle-aged and elderly patients].

On the basis of examination and treatment of 364 elderly and senile patients with obstructive jaundice and cholangitis, the authors conclude that the frequency of these complications is high and that cholangitis takes an atypical course in patients over 60 years of age. They determine the significance of the respiratory insufficiency syndrome in manifestation of the severity of the disease. In view of the high risk of surgery at the peak of jaundice and cholangitis, the authors suggest the wide use of endoscopic papillosphincterotomy according to indications for correcting biliary hypertension.

[Acute cholecystitis and its complications].

The results of operative treatment of 4,011 patients with acute complications of cholecystitis are analysed. Problems of diagnosis and tactics and the results of treatment are discussed. It is pointed out that the management of patients with acute complicated cholecystitis is a great and urgent problem in abdominal surgery in view of the diffuse character of the process.

[Late results of endoscopic papillosphincterotomy in patients with non-neoplastic diseases of the common bile duct].

An investigation of long-term results of treatment of 226 patients has shown that endoscopic papillosphincterotomy is a highly effective method of treatment of patients with cholelithiasis and stenosis of the major duodenal papilla. The complex use of the surgical and endoscopic methods of treatment gave most favorable results.

[Endoscopic papillosphincterotomy in the treatment of choledocholithiasis and its complications].

Endoscopic papillosphincterotomy was performed in 306 patients with hepatocholedochal calculi. Mechanical jaundice was found in 271 patients (88.5%), 183 patients (59.

[Endoscopic retrograde cholangiopancreatography in the diagnosis of diseases of the organs of the hepato-pancreato-duodenal group].

Experience with using endoscopic retrograde pancreatocholangiography (ERPCG) in 278 patients has shown the method to be the most valuable one in preoperative diagnosis of diseases of bile ducts. It facilitates establishing the presence of calculi in bile ducts, diagnosis of stenosis of the major duodenal papilla and cholangitis. ERPCG allows establishing the localization of a tumor process in bile ducts.

[Late results with a deep suture of the common bile duct].

Analysis of long-term results has shown that the primary suture of the common bile duct is quite a reliable method for completing choledochotomy provided it is used in case of good patency of bile eliminating ducts having no concrements.

[Endoscopic papillosphincterotomy].

The authors analyze the experience with the employment of the endoscopic papillosphincterotomy in 102 patients with choledocholithiasis and stenosis of the major duodenal papilla, discuss the indications and contraindications to this operation. A comparative assessment of different methods of dissection of the major papilla was made; the effectiveness of the operation, complications and methods for their prevention are analyzed.

[Retrograde cholangiopancreatography and endoscopic papillotomy in mechanical jaundice].

The authors believe that in jaundices of a mechanical type the endoscopic retrograde cholangiopancreatography should be considered the first and foremost diagnostic method and fulfilled in every patient with symptoms of mechanical jaundice. They believe that in order to eliminate the full cholestasis and cholemia in a certain contingent of patients it is expedient to perform endoscopic papillotomy which is followed by spontaneous passage of stone into the intestine.

[Pulmonary embolisms as a complication of acute arterial obstruction of the lower extremities].

This is an analysis of 130 cases with embolism of the pulmonary artery with a lethal outcome, which had developed in patients suffering from occlusion of the lower extremities. It is noted that the origin of embolism of the system of the pulmonary artery depends on the severity of ischemia of the tissues of the affected extremity and pointed out that this menacing complication develops both in the stage of ischemia and in the postischemic period. For the prevention of pulmonary embolism in patients with severe ischemia or gangrene of the lower extremities, it is recommended that operative treatment (corrective operations on the arteries or amputation) should be combined with inspection of the major veins.