Biomedical subjects
Publications and source records attributed to A V Kostyrnoĭ.
The prospective investigation a was conduct in 218 patients and retrospective ones--in 253 patients. The results of drainage operations in infectious forms of pancreonecrosis were studied basic task in preoperative period was adequate antibacterial therapy, directed on all microorganisms.
The variants of an operative intervention completion were analyzed in 197 patients with purulent-necrotic complications of an acute pancreatitis. There were studied up the advantages and faults of various methods of drainage of purulent-necrotic focus in bursa omentalis and in retroperitoneal space cellular tissue.
There were examined 130 patients with postnecrotic pancreatic cyst (PNPC). In 16.2% of them the cause of the cyst formation was not established. Operative intervention performance is indicated after establishment of the PNPC diagnosis before occurrence of complications.
New hypothesis of the pancreatic pseudocyst (PPC) pathogenesis, intending detachment of nourishing "segment" of the organ as the source of the cystic cavity filling, is presented. An experiment on forming of internal anastomosis with cystic cavity and pancreatic duct was done. The model of suppurated PPC was elaborated, to treatment of which the ointments levosin and ophlotrimol, possessing noncorrect necrolytic activity, were applied. In experimental investigations the perspective of conduction of the PPC (already formated and "unripe" as well) curative decompression was shown and efficacy of the ointment compositions for the treatment of suppurated PPC too.
Difficulties in diagnosis of an acute pancreatitis and its purulent-necrotic complications are caused by peculiarities of localization of pancreas. Complex estimation of clinical signs, the laboratory and instrumental investigations data are permitting to analyze correctly clinical situation and to choose an optimal variant of the patient treatment program.
While investigation of pancreatic gland on 133 specimen of the organ it was established, that in edematous pancreatitis the ductal system is hermetic and when the organ destruction occurs--its integrity is compromised. In the occurrence of purulent necrotic complications of an acute pancreatitis the contrast substance "exit" is characteristic; via the lowest ranking ducts in the para-pancreatic cellular tissue necrosis and via the highest ranking ducts--in retroperitoneal phlegmon.
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The experience of treatment of 860 patients with purulent-necrotic complications of an acute pancreatitis was summarized. The complex approach, the methods of an organism detoxication application, the operative procedure optimization permit to stop the purulent-necrotic process progress and to perform the operative intervention in the period of time, favourable for the patient.
Performance of complex examination using endoscopic pancreatography permitted to study the pancreatic ductal system state, disorder of which constitutes an objective criterion in diagnosis of chronic pancreatitis and in the choice of optimal volume of operative intervention.
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There were examined 80 patients with fistula of various localization as complication of an acute pancreatitis.