[The use of laparoscopy in the differential diagnosis of a complicated aneurysm of the abdominal aorta and acute pancreatitis].
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Biomedical subjects
Publications and source records attributed to A V Kapshitar'.
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Within the recent 5 years, the authors observed 103 sufferers with penetrating injury to the abdomen. Operated on were 79 patients. Of them, 39 underwent explorative laparotomy. Laparoscopy was performed in obscure diagnosis in sufferers with associated trauma who were unconscious, in those with the signs of alcohol intoxication, in drug addicts etc. The advantages of the use of laparoscopy in the diagnosis, and in some patients--in the treatment of injuries were noted.
The results of laparoscopy performed in 108 patients with acute pancreatitis previously operated on the abdominal organs and anterior abdominal wall are analysed. The technique of investigation has its peculiarities: choice of the points for introduction of a manipulator and laparoscope, circumscribed pneumoperitoneum, moving of a patient on the operating table. In previously operated patients, laparoscopy is not contraindicated, but it should be performed by an experienced endoscopist. Operated on were 16 patients. Nine died. There were no complications and lethal outcomes related to laparoscopy.
As many as 988 patients with acute pancreatitis were given hospital treatment at the clinic of general surgery, its total duration being three years. Atherosclerosis of vessels was identified in 616 (62%). Difficulties with clinical diagnosis occurred in patients with moderately severe to severe degree of atherosclerosis (62%). Laparoscopy appeared to be undoubtedly superior to other diagnostic aids employed. Conservative therapy was found to be effective in 557 patients. Postoperative case mortality was 6 patients with destructive forms of pancreatitis.