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Biomedical subjects

A I Nechaĭ

Publications and source records attributed to A I Nechaĭ.

At least 19 recordsLinked to original sources
PubMed1998

[Recurrent and residual choledocholithiasis].

Many years' experience in treatment of 617 patients with choledocholithiasis (ChDL) served the basis for analysis of the causes of residual (72.4%) and recurrent (21.4%) lithiasis of bile ducts in patients with postcholecystectomy syndrome. In 6.2% of cases identification of the type of ChDL was not a success. Recommendations in prophylaxis of recurrent as well as residual lithiasis are given. In 78.5% of patients with residual stones after primary operation choledochotomy with removal of the stones was made with cholecystectomy but as was evidenced later not all the stones were removed. Data on diagnostic value of clinical symptoms and US examinations for revealing ChDL are presented. ChDL without jaundice was detected in 47.4% of patients. Current diagnostic facilities in primary choledocholithiasis before the operation and intraoperative are discussed. After choledochotomy, if there are no contraindications, it is recommended to finish the operation by external drainage of bile ducts with the use of T-shaped drainage tube. If residual ChDL is detected, it would be reliably eliminated without surgery.

Choledochostomy↗
PubMed1995

[Selective surgical cholangiography].

Based on an analysis of data of ultrasonic examinations, cholangiography and operative findings, the authors consider that intraoperative cholangiography is necessary but in 48% of patients. The article gives grounds for indications to intraoperative cholangiography.

Bile Duct Diseases↗
PubMed1993

[The causes of the so-called post-cholecystectomy syndrome and the possibilities of its timely recognition].

A simple scheme for the examination of patients for identifying the causes of the so-called postcholecystectomy syndrome (PCES) is suggested from experience in the examination of 1,712 patients with this syndrome. Three groups of patients are distinguished. First group--individuals with an external biliary fistula. Second group--patients with jaundice or with signs of jaundice suffered in the past after an operation. Third group--patients with abdominal pain and dyspeptic disorders after removal of the gallbladder but without an external biliary fistula and jaundice. The author gives a clinical evaluation and recommendations for using in establishing the diagnosis ultrasonic examination, cholefistulography, intravenous cholegraphy, percutaneous transhepatic cholangiography, retrograde cholangiopancreaticography, and computerized tomography conformably to the distinguished groups. After the examination was completed, the need for a repeated operation or active treatment (endoscopic papillotomy, removal of stones through the fistula) occurred in 98.7% of patients of the first group, in 73.8% of those in the second group, and in 15.7% of patients of the third group.

Humans↗
PubMed1990

[Evaluation of the effectiveness of vagotomy in uncomplicated duodenal ulcer based on its results 10 years after the operation].

Under analysis are results of vagotomy performed in 95 patients with uncomplicated ulcer of the duodenum after ineffective conservative treatment 10 years after operation. During this time recurrent ulcer developed in 26 patients (27.4%). The disease reappeared more frequently in patients with high level of night gastric secretion before surgery. Results of the operation in 25 patients (26.3%) could be estimated only as satisfactory because of various disorders (dumping-syndrome, diarrhea, gastric dyspepsia). But a usual basis for such an assessment was not a medial degree of some disorders (2 patients) but a combination of light degree disorders (23 patients). One patient was included into the IVth Wisik's group due to severe dyspepsia. Only 43 patients (45.3%) were included in the I and II groups by the Wisik's scheme. Results of vagotomy in patients who had no ulcer complications before operation were compared with the efficiency of vagotomy used totally for all indications and were found to be much worse. The authors make a conclusion that it is not expedient to widen indications to vagotomy at the expense of patients with uncomplicated ulcers.

Contraindications↗
PubMed1990

[The characteristics of the morphological changes in the gastric mucosa in duodenal peptic ulcer, ulcer recurrence after vagotomy and in the Zollinger-Ellison syndrome].

Results of morphometry and count of certain kinds of endocrinocytes of gastric mucosa are analyzed. Pronounced proliferative alterations of the gastric mucosa were found with clear signs of the increased function of the structures responsible for acid gastric secretion. In part of the patients with ulcer disease of the duodenum there are considerable changes in the amount of certain kinds of endocrinocytes of the antral portion of the stomach, which form accumulations in the form of different fields and even focal zones. Such alterations in the gastric mucosa have correlative relationships with the level of acid gastric secretion.

APUD Cells↗
PubMed1990

[Diagnosis of adrenal gland tumors].

An experience with diagnozing tumours of the adrenals in 159 patients has shown that overwhelming majority of the patients had hormonal disorders. Most important clinical signs taking place in various neoplasms of the adrenals were established. The minimum necessary volume of information is pointed out which must be obtained at each step of diagnozing.

Adenoma↗
PubMed1990

[Atropine resistance and its significance in the selection of the method of surgical treatment of duodenal ulcer].

Medical vagotomy with atropine allows two types of patients with duodenal ulcer to be distinguished--atropine-resistant and atropine-sensitive. A complicated course of the disease, high values of nocturnal gastric secretion before the operation, and positive Hollander's insulin test after vagotomy are encountered most frequently in atropine-resistant patients. The values of gastrin are significantly higher in these patients than in atropine sensitive patients. In 3-year follow-up periods, recurrence of the ulcer after vagotomy was revealed in 6.5% of atropine-resistant patients but in none of the atropine sensitive patients. Medical vagotomy with consideration for atropine sensitivity may be a reliable prognostic criterion in the choice of the operative intervention in patients with duodenal ulcer.

Atropine↗