[Prospects of intraoperative dynamic cholangio-manometry by tensor detectors with graphic recording of pressure function].

Intraoperative cholangio-manometry with a miniature tensor sensor and graphic recording of the results were conducted to study the function of the major duodenal papilla in 53 patients. A periodical activity of the ampulla of the papilla was revealed, which was characterized by certain values of the peak and basal pressure, and duration of contraction and relaxation periods. The numerical values and the pattern of the pressure curve differed in patients with obstructive cholecystitis, biliary pancreatitis, and a concrement incarcerated in the ampulla of the papilla.

[Lesions of the biliary system in primary extrahepatic portal hypertension].

The authors describe extensive strictures of the hepaticocholedochus, ranging from 2.5 cm in length to total involvement of the duct, in 15 patients with primary extrahepatic portal hypertension. In 7 patients they were combined with cystic dilatation of the intrahepatic bile ducts.

[Surgical treatment of strictures of the hepaticocholedochus in patients with primary extrahepatic portal hypertension].

An analysis of their experience with treatment of 14 patients has shown that treatment of prolonged strictures of hepaticocholedochus in patients with extrahepatic portal hypertension by conservative measures is not sufficiently effective. The optimum surgical treatment is operation for reestablishment of the bile outflow. Hepaticojejunostomy is most reliable.

[Peritoneovenous shunt in resistant ascites in patients with portal hypertension].

Experience in 100 operations for the creation of a peritoneovenous shunt in 63 patients with portal hypertension and resistant ascites showed that in careful selection of patients and determination of contraindications this operation is an effective method for the treatment of resistant ascites in patients with portal hypertension. The shunt increases diuresis, reduces the volume of the abdomen, makes laparocentesis unnecessary, improves the patients' general condition and allows some of them to be prepared for interventions on the organs of the portal system which are more radical in character.

[Pathogenesis of esophagitis in patients with portal hypertension].

Acidogenic function of the stomach and role of gastroesophageal reflux were assessed in relation to esophagitis genesis in 92 patients with portal hypertension and varicosity of the stomach and esophagus. Acidogenic function was found heterogenous. The relationship between gastric acidity, gastroesophageal reflux and esophagitis development seemed obscure, whereas that between esophageal varicosity of a definite degree and esophagitis was clear-cut.

[Endoscopic papillosphincterotomy in patients with acute cholecystitis and lesions of the common bile duct].

The authors analyse treatment of 115 patients who were admitted for acute cholecystitis with involvement of the bile ducts which manifested itself as a rule, as obstructive jaundice and cholangitis. Endoscopic papillosphincterotomy (EPST) was conducted as the first stage of treatment in 83 patients, as the second stage after cholecystectomy or laparoscopic cholecystotomy in 30, and during the surgical intervention in 2 patients. Experience shows that treatment of this contingent of patients in two stages is advisable.

[Contraindications to splenectomy in primary total extrahepatic portal hypertension].

The authors studied changes of hepatic circulation, hepatoportal hemodynamics, and homeostasis of peripheral and portal venous blood in response to removal of the spleen in primary total extrahepatic portal hypertension. The findings of rheohepatography, isotope hepatography, and ultrasonic flow measurement provided proof that splenectomy does not lead to intensification of the flow of arterial blood to the liver. Study of the portal pressure level did not demonstrate any significant hypotensive effect of splenectomy.

[Our judgements on the potential for surgical treatment of patients with liver cirrhosis and portal hypertension].

The results of surgery of 267 patients with liver cirrhosis and portal hypertension were analyzed. Operation was indicated in actual danger of bleeding from varicose dilated esophageal and gastric veins; surgical intervention should be limited to selective portocaval anastomoses or to direct operation on esophageal and gastric veins. Indications for splenectomy in such patients should be limited.

[Prevention and treatment of complications of acute pancreatitis].

Results of treatment of 156 patients with acute pancreatitis (with the first attack of the disease) were analyzed. These patients had 284 early and 76 late complications of the disease. Causes of the complications observed are discussed.

[Endoscopic placement of a jejunal tube and a method of conducting enteral feeding with special mixtures].

The endoscopic placement of a nasoenteral probe for jejunal nutrition can be brought about by four main technical modes: conducting the probe through the biopsy canal of the endoscope, placement along the string, parallel introduction with the endoscope and combination of the above methods. An emulsion product containing 1 kkal/ml, macro-, microelements, vitamins was used for the enteral nutrition. Three main methods of enteral probe nutrition were used depending on specificity of the main disease, character of functional disorders of the intestine and the presence of inflammation in digestive organs.