[Diagnostic and management algorithm of acute pancreatitis].

The analysis of diagnostics and treatment of 602 patients with destructive pancreatitis has shown that definition of etiological and pathogenetic forms of pancreatitis defines strategy of treatment. In this way, patients with biliary pancreatitis require emergency operative treatment with use of endoscopic interventions without dependence from a stage of disease. To patients with alcoholic or alimentary pancreatitis in the stage of enzymatic toxemia conservative treatment should be spent only, until shock and/or delirium won't be reduced.

[Syndrome of compression of the celiac trunk of the abdominal aorta in adults].

The article presents results of examinations and surgical treatment of 300 patients aged from 19 through 72 years with the syndrome of compression of the celiac trunk of the abdominal aorta. Under study were the symptoms and features of the clinical course as well as the possibilities of diagnosis with the help of ultrasonic duplex scanning and aortography. The principal method of treatment of this syndrome is thought to be operative decompression of the celiac trunk resulting in the reestablished hemodynamics in this vessel and in recovery of the greatest part of the patients.

[Possibilities of x-ray computed tomography in the diagnosis and treatment of suppurative complications of acute pancreatitis].

The authors have analyzed results of the roentgen computed examination of 73 patients with acute pancreatitis and its complications. The potentialities of roentgen computed tomography (RCT) in diagnosing are shown as well as computed semiotics of acute pancreatitis and its complications. The authors consider that RCT makes the diagnosis substantially more exact and enables the complications to be detected much earlier.

[Immune and enzyme disorders in patients with acute pancreatitis].

Analysis of immune and enzyme disorders in 85 patients with acute pancreatitis shows that persistent imbalance of immunoregulatory T-lymphocytes with suppression predominance; reduction of all immunoglobulines number, imbalance in phagocytic immunity with height of absorbing activity of neutropils and stimultaneous decrease of their digestive capacity are prognostically unfavourable for high risk of pyonecrotic complications and lethal outcome. It is necessary to include immunocorrectors in combined therapy. Direct assessment of leukocytic elastase activity and alpha-IP level in blood plasma permits to evaluate spreading of inflammatory process and it severity, efficacy and prognosis of treatment.

[Experience with chemotherapy for advanced pancreatic carcinoma].

The effectiveness of different regimens of chemotherapy for advanced pancreatic cancer was compared in 74 cases (1995-1999). 5-fluorouracil (5FU), adriamycin and mitomycin C (FAM) were given to 12 patients, 5FU alone--23, 5FU plus leukovorin--29, and gemcitabine alone--10. Metastases to the liver were detected in 42 (57%) patients.

[Enteral correction of homeostasis in acute pancreatitis].

The experiments showed that heart and liver functional abnormalities will take place even before changes of blood amylase is occurred. It was shown that Dalargin in a dose of 50 micrograms/kg will stimulate the intestinal absorption.

[Leukinferon in immunological correction of acute inflammatory diseases of the abdominal organs].

Addition of (intramuscular+intravenous) leukinferon (LF) to the schemes for the treatment of acute peritonitis promoted a more rapid positive development of the time course of clinical signs and decreasing of leukocytosis in the presence of a pronounced tendency to normalization of the main immunological indices i. e. the counts of differential T-lymphocytes and T-helper cells.

[Treatment of patients with late thrombosis after reconstructive surgery of the terminal segment of the aorta and its branches].

An analysis of personal clinical observations (339 patients) has been performed. In 45 of the patients (13.3%) late thromboses developed within the period from 3 months to 5 years.

[Treatment of depressed skull fractures].

On the basis of differentiated surgical management of 276 patients with depressed fractures of the skull the authors proved the efficacy of bone-preserving operations and accomplishing all surgical manipulations in a single stage with the conduction of primary cranioplasty. The justification of performing all stages of surgical treatment during the patient's first stay at the hospital with the conduction of cranioplasty in three stages is substantiated. It is shown that differentiated treatment of depressed fractures improves the results and shortens the period of social and working readaptation of the patients.