scholarly journals THE USE OF ANTEGRADE ENDOBILIARY INTERVENTIONS IN BENIGN DISEASES OF THE BILIARY TRACT COMPLICATED BY MECHANICAL JAUNDICE

2021 ◽  
pp. 10-12
Author(s):  
D. O. Yevtushenko ◽  
I. A. Taraban ◽  
Yu. V. Avdosyev ◽  
A. L. Sochneva ◽  
D. V. Minukhin ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Biliary Tract ◽  
Endoscopic Treatment ◽  
Percutaneous Transhepatic Cholangiography ◽  
Benign Diseases ◽  
Biliary Decompression ◽  
Unsuccessful Attempt ◽  
Biliodigestive Anastomosis ◽  
Percutaneous Transhepatic Cholangiodrainage ◽  
The Right

Introduction. One of the most common manifestations of diseases of the biliary tract are strictures or stenoses. They can have malignant, inflammatory and traumatic etiology, as well as be accompanied by mechanical jaundice syndrome. Aim. To study the results of the use of antegrade endobiliary interventions in benign diseases of the biliary tract complicated by mechanical jaundice. Materials and methods. An analysis of surgical treatment of 34 patients with benign diseases of the biliary tract complicated by mechanical jaundice (MJ) in the SI “V.T. Zatsev IGUS NAMSU». Choledocholithiasis was the cause of MF in 21 (61.8 %) cases, stricture of the LV in 6 (17.6 %) and stricture of the biliodigestive anastomosis (BDA) in 7 (20.6 %) patients. BDA strictures developed after the following operations: biliobiliostomy — 1 (14.3 %), hepaticojejunostomy — 3 (42.9 %), choledochoduodenoanastomosis — 2 (28.5 %) and hepaticoduodenostomy — 1 (14.3 %) %). Research results. External percutaneous transhepatic cholangiodrainage was performed in 7 (46.7 %) patients, external-internal percutaneous transhepatic cholangiodrainage was performed in 6 (40 %), percutaneous transhepatic cholecystostomy was performed in 2 (13.4 %) patients. With slightly dilated intrahepatic ducts (<5 mm) cholangiodrainage was established in 3 (20 %) patients. Of these, in 3 (20.0 %) cases, a separate percutaneous transhepatic cholangiodrainage of the right and left lobular ducts of the liver was performed. Performing percutaneous transhepatic cholangiography and percutaneous transhepatic cholangiodrainage allows to determine the level and nature of biliary block in a minimally invasive way, to perform biliary decompression and prevention of complications after an unsuccessful attempt at endoscopic treatment. Conclusions. By using antegrade endobiliary interventions, we were able to reduce the risk of biliary decompression complications compared with patients who had unsuccessful attempts at endoscopic treatment from 15 (78.9 %) to 1 (6.67 %), and to reduce the number of complications after reconstructive rehabilitation. operations from 10 (52.6 %) to 1 (6.67 %) and the mortality rate from 2 (10.5 %) to 1 (6.67 %).

PERCUTANEOUS TRANSHEPATIC CHOLANGIOGRAPHY IN THE DIAGNOSTICS OF COMMON BILE DUCT DISEASES COMPLICATED BY OBSTRUCTIVE JAUNDICE*

2021 ◽  
Vol 8 (2) ◽  
pp. 62-67
Author(s):  
Valeriy V. Boyko ◽  
Yuriy V. Avdosyev ◽  
Anastasiia L. Sochnieva ◽  
Denys O. Yevtushenko ◽  
Dmitro V. Minukhin
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Obstructive Jaundice ◽  
Biliary Tract ◽  
Percutaneous Transhepatic Cholangiography ◽  
Biliary Decompression ◽  
Biliodigestive Anastomosis ◽  
Bile Duct Diseases

Aim: Evaluation of the effectiveness of percutaneous transhepatic cholangiography in the diagnostics of bile duct diseases complicated by obstructive jaundice. Material and methods: This article presents the experience of using percutaneous transhepatic cholangiography in 88 patients with benign and malignant common bile duct diseases complicated by obstructive jaundice. Results: Methods of direct contrasting of the biliary tract make it possible to visualize choledocholithiasis with 86.5% accuracy, with 84.1% common bile duct strictures, with 87.8% stricture of biliodigestive anastomosis and with 97.5% accuracy of cholangiocarcinomas. Conclusions: Direct antegrade bile duct enhancement should be used if ERCPG has low explanatory value. PTCG in case of “endoscopically complicated forms” of choledocholithiasis, CBD and BDA strictures and cholangiocarcinomas enhances all bile duct sections and helps assess the level and completeness of biliary blockade. Following PTCG, measures can be taken to achieve biliary decompression regardless of OJ genesis.

scholarly journals Biliary decompression in patients with obstructive jaundice

2019 ◽  
pp. 24-31
Author(s):  
V. L. Korobka ◽  
S. V. Tolstopyatov ◽  
R. O. Dabliz ◽  
A. M. Shapovalov
Keyword(s):  
Surgical Treatment ◽  
Mortality Rate ◽  
Obstructive Jaundice ◽  
Biliary Tract ◽  
Palliative Treatment ◽  
Biliary Decompression ◽  
Surgical Access ◽  
Final Treatment ◽  
Tumor Origin ◽  
Overall Mortality

Aim. Evaluation of the biliary tract decompression methods and their use results, in patients with obstructive jaundice of various etiologies on the basis of our own clinical material.Material and Methods. A retrospective analysis of the biliary tract drain results in 6935 patients with obstructive jaundice with benign and tumor etiology. In 87% cases there was B Class of obstructive jaundice. In 93% we observed mild (A Class) obstructive jaundice. For the biliary tract drainage we used laparoscopic or open surgical access. The retrograde drain we used in sixty-seven percent cases with obstructive jaundice B Class. In sixty-six percent cases of obstructive jaundice C Class, we used antegrade drain.Results. The biliary decompression was effective in 98%. Regarding the rate and timing of bilirubin reduction, all the applied methods showed a similar result, however, the greatest number of complications and fatalities we recorded in patients after antegrade percutaneous drain of the biliary tract and transabdominal access. In 36% the performed interventions became the final treatment option, and the sixty-one percent of patients underwent two-stage treatment. The overall mortality rate was 3%.Conclusion. The use of percutaneous drainage is justified for obstructive jaundice with tumor origin, and possible radical surgical treatment. Transabdominal access drainage for benign etiology of obstructive jaundice in compensated patients can be safely used. Transduodenal endoscopic drain is an alternative to other methods biliary tract drain in severe and medium obstructive jaundice of benign etiology. The same drain method can be used for drainage of biliary tract in patients with tumors of the hepatopancreatobiliary zone organs, as a palliative treatment. 

scholarly journals ENDOSCOPIC TREATMENT OF ARACHNOID CYSTS OF THE MIDDLE CRANIAL FOSSA IN CHILDREN

2020 ◽  
pp. 390-397
Author(s):  
R.A. SUFIANOV ◽  
◽  
M.M. ABDUMAZHITOVA ◽  
R.R. RUSTAMOV ◽  
A.A. SUFIANOV ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Endoscopic Treatment ◽  
Middle Cranial Fossa ◽  
Speech Development ◽  
Arachnoid Cysts ◽  
Total Efficiency ◽  
Symptomatic Epilepsy ◽  
Cranial Fossa ◽  
The Right ◽  
Observation Period

Objective: Improvement of the results and effectiveness of endoscopic treatment for arachnoid cysts of the middle cranial fossa (AC MCF) in children. Methods: At the Federal Center for Neurosurgery of Tyumen 65 patients with AC MCF were operated from 2012 to 2018 by endoscopic cystocisternostomy (ECCS). Patients age ranged from one month up to 17 years. Children under 3 years old were – 32 (49%). Hypertensive symptoms were in 26 (40%); delayed speech development in 20 (31%); symptomatic epilepsy in 12 (18.5%); pathology of the ocular fundus was in 5 (7.7%). Associated abnormalities were in 19 (29%). All patients underwent CT and/or MRI. In 46 (71%) patients, cysts were located on the right, in 13 (20%) on the left and 6 (9%) bilateral. The displacement of the middle structures was diagnosed in 45 (69%). According to the Galassi classification: type II was in 20 (31%), type III – in 45 (69%) patients. The average volume of AC MCF before the operation was 181±18.6 cm3. All 65 patients underwent ECCS: a miniature neuroendoscope KarlStorz – Endoskop 11576 KF/KG was used in 47 patients, and a standard rigid endoscope LOTTA, «Gaab I scope» or flexible video scope was used in 18 patients. Results: The postoperative observation period ranged from 1 year to 8 years. The volume of cysts after surgery averaged 124.8±17.2 cm3. On average, the volume of cysts decreased by 58.2±13.5 cm3. The total efficiency of ECCS in 65 patients with AC MCF reached 81.5% of cases. Relapse was noted in 14 patients (22%). The period of recurrence ranged from 1 month to 81 month. Recurrence was in 71% of children under the age of 3 years. There was a correlation between repeated interventions and age. Children under 3 years of age have the efficiency of surgical treatment at 68.8% than in children over 3 years old – 93.8% (p≤0.01). The results of surgical treatment, depending on the endoscope used, were statistically unreliable, because when using Karl Storz – Endoskop 11576 KF/KG the total efficiency was 81%, and when using LOTTA, «Gaab I scope» or a flexible video scope – 84%. Complications in the postoperative period occurred in 6 (9%) children. Conclusions: The effectiveness of ECCS in 65 children with AC MCF reached 81.5% of cases. The effectiveness of ECCS in children under 3 years of age was 68.7%, and 93.7% in children older than 3 years. Keywords: Middle cranial fossa , arachnoid cysts in children, intracranial cyst, endoscopic treatment, endoscopic cystocisternostomy.

scholarly journals Surgical treatment for common hepatic aneurysm. Original one-step technique

Open Medicine ◽  
2020 ◽  
Vol 15 (1) ◽  
pp. 898-904
Author(s):  
Bruno Amato ◽  
Renato Patrone ◽  
Gennaro Quarto ◽  
Rita Compagna ◽  
Roberto Cirocchi ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Hepatic Artery ◽  
Distal Part ◽  
Intraoperative Ultrasound ◽  
Section Area ◽  
One Step ◽  
A New Technique ◽  
Open Surgical Treatment ◽  
The Right ◽  
Vascular Stapler

AbstractIntroductionHepatic artery aneurysms are rare, and their treatment represents a challenge for the surgeons.Materials and methodsA new technique is presented for common hepatic artery (CHA) aneurysm: it requires minimal vascular surgical dissection and only one linear vascular stapler is applied at the bottom of aneurysm. Aneurysm exclusion is easily obtained, which allowed retrograde thrombosis. Liver blood supply is ensured to the right and left hepatic artery, through the gastroduodenal artery, and can be previously monitored, with temporary clamping of the section area, by visual control, enzyme evaluation and intraoperative ultrasound examination. We reported an open surgical treatment, with simultaneous removal of hepatic and adrenal metastases, secondary to colon cancer.ResultsThe duration of vascular surgery was 30 min and did not involve complications. Postoperative controls confirmed the efficacy of the procedure.DiscussionThis original technique can be added to the various open and endovascular techniques so far described for the treatment of a CHA aneurysm. It is advisable as open surgery, mostly in case of associated pathologies.ConclusionsThe authors believe that this “one shot” technique by vascular staple of the distal part of CHA is minimally invasive and effective to obtain the exclusion of the aneurysm.

Successful surgical treatment of a giant coronary aneurysm communicating with the right atrium

2007 ◽  
Vol 8 (12) ◽  
pp. 1061-1064 ◽  
Author(s):  
Andrea Rognoni ◽  
Valeria Ferrero ◽  
Giovanni Teodori ◽  
Flavio Ribichini
Keyword(s):  
Surgical Treatment ◽  
Right Atrium ◽  
Coronary Aneurysm ◽  
Giant Coronary Aneurysm ◽  
The Right

ENDOSCOPIC TREATMENT OF BILIARY-TRACT DISEASES

The Lancet ◽  
1979 ◽  
Vol 313 (8112) ◽  
pp. 377-378
Author(s):  
RogerW. Motson
Keyword(s):  
Biliary Tract ◽  
Endoscopic Treatment ◽  
Biliary Tract Diseases

Czech Social Democracy and its “cohabitation” with the Communist Party: The story of a neglected affair

2008 ◽  
Vol 41 (3) ◽  
pp. 317-338 ◽  
Author(s):  
Lubomír Kopeček ◽  
Pavel Pšeja
Keyword(s):  
Communist Party ◽  
Democratic Party ◽  
Social Democratic Party ◽  
Pragmatic Approach ◽  
Social Democrats ◽  
Unsuccessful Attempt ◽  
Social Democratic ◽  
The Social ◽  
The Right ◽  
The Relationship

This article attempts to analyze developments within the Czech Left after 1989. Primarily, the authors focus on two questions: (1) How did the Czech Social Democratic Party (ČSSD) achieve its dominance of the Left? (2)What is the relationship between the Social Democrats and the Communist Party of Bohemia and Moravia (KSČM)? We conclude that the unsuccessful attempt to move the KSČM towards a moderate leftist identity opened up a space in which the Social Democrats could thrive, at the same time gradually assuming a pragmatic approach towards the Communists. Moreover, the ability of Miloš Zeman, the leader of the Social Democrats, to build a clear non-Communist Left alternative to the hegemony of the Right during the 1990s was also very important.

SUCCESSFUL SURGICAL TREATMENT OF THROMBOSIS OF THE RIGHT ATRIUM IN A CHILD WITH STEROID-RESISTANT NEPHROTIC SYNDROME

2018 ◽  
Vol 13 (3) ◽  
pp. 145-146
Author(s):  
M.A. MARTAKOV ◽  
E.M. ZAJNETDINOV ◽  
V.P. PRONINA ◽  
N.V. SHESTERIKOV ◽  
V.V. SHESTERIKOVA ◽  
...  
Keyword(s):  
Nephrotic Syndrome ◽  
Surgical Treatment ◽  
Right Atrium ◽  
Steroid Resistant ◽  
Steroid Resistant Nephrotic Syndrome ◽  
The Right

scholarly journals Reconstruction of the Adult Hemifacial Microsomia Patient with Temporomandibular Joint Total Joint Prosthesis and Orthognathic Surgery

2018 ◽  
Vol 2018 ◽  
pp. 1-6 ◽  
Author(s):  
Piero Cascone ◽  
Valentino Vellone ◽  
Valerio Ramieri ◽  
Emanuela Basile ◽  
Achille Tarsitano ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Temporomandibular Joint ◽  
Distraction Osteogenesis ◽  
Orthognathic Surgery ◽  
Joint Prosthesis ◽  
Hemifacial Microsomia ◽  
Primary Methods ◽  
Jaw Reconstruction ◽  
The Right ◽  
Reconstructive Techniques

Background. HFM patients’ reconstruction has always been a challenge for maxillofacial surgeons, and numerous reconstructive techniques have been described. Surgical treatment depends on the patient’s age and contemplates Temporomandibular Joint (TMJ) reconstruction in conjunction with orthognathic surgery, usually necessary following completion of growth to maximize the functional and esthetic results. Distraction osteogenesis had gained popularity as valid alternative in growing patients, but the two primary methods to reconstruct the TMJs involve the use of autogenous, using free or microvascular bone grafts, or alloplastic graft, but there is no widely accepted method. Methods. The increasing use of temporomandibular prosthesis for temporomandibular problems has led us to use them even in HFM. A case of female nongrowing patients with HFM type IIb treated with temporomandibular prosthesis in an all-in-one protocol is presented. Results. Incisal opening, measured with BioPAK system (Bioresearch Inc., Milwaukee, USA), was 21.4 mm in the presurgical period and 32.2 mm after all-in-one procedure, for an increase of 50.5%. Excursive movement to the right side was 2.2 mm in the presurgical period and was 1.5 mm after surgery, for a decrease of 31.8%. Left excursion movement changed from 5 mm to 6.1 mm, for an increase of 22.0%. Conclusions. The TMJ Concepts patient-fitted TJP in conjunction with orthognathic surgery for TMJ and jaw reconstruction is a valid option for patients with HFM.

scholarly journals The principles of planned surgical treatment of chronic duodenal ulcer(40-years experience of Clinic named for S.P. Fyodorov)

2007 ◽  
Vol 6 (3) ◽  
pp. 38-42
Author(s):  
N. A. Maystrenko ◽  
A. A. Kurygin ◽  
Al. A. Kurygin
Keyword(s):  
Duodenal Ulcer ◽  
Surgical Treatment ◽  
Diagnostic Algorithm ◽  
Chronic Duodenal Ulcer ◽  
The Right

The experience of planned treatment more than 2 000 patients with chronic duodenal ulcer makes it possible to work out the diagnostic algorithm, based on complex research of acidic stomach secretion. The principles of choosing of interference (organ-retaining, resecting or combining interference) and kind of pyloroplasty were defined. The right choice of operation of complicated duodenal ulcer secures excellent and good results for 85% patients.

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