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A V Skums

Publications and source records attributed to A V Skums.

At least 19 recordsLinked to original sources
PubMed2006

[Surgical correction of the biliary ducts injury while performance of laparoscopic cholecystectomy].

There were analyzed the results of treatment of 65 patients, in whom unintended injury of biliary ducts occurred while performance of laparoscopic cholecystectomy in 1993-2005 yrs, including 9 patients, operated in the clinic and 56--in other hospitals. For correction of intraoperatively revealed injuries of biliary ducts there were formated bilio-biliary anastomosis, cholecystoenteroanastomosis--in 1, hepaticojejunoanastomosis end to side (in 2), "high" hepaticojejunoanastomosis (in 5). If the injuries were revealed more lately, application of two-staged treatment was needed in majority of cases. Miniinvasive intervention, as the definitive method of correction, was applied in 11 patients with small injury of biliary ducts, insufficiency of the gallbladder stump sutures due to residual choledocholithiasis, and also as an additive manipulation in the treatment of complete injury of biliary ducts--in 23. Postoperative mortality was 1.5%, and in late period--1.5%.

Adult↗
PubMed2005

[Complex treatment of patients with cholangiogenic hepatic abscess].

Results of treatment of 47 patients with cholangiogenic hepatic abscess were analyzed. Clinical, laboratory and special methods of investigation were applied for diagnosis. The authors consider ultrasound investigation (USI), computer tomography and the abscess puncture under the USI control with subsequent cytological and bacterial control the decisive methods in diagnosis of hepatic abscess. In complex of treatment of patients miniinvasive technologies were applied--the abscess puncture, its cavity drainage under USI control transcutaneus transhepatic cholangiostomy, endoscopic papillosphincterotomy with lithotripsy and nasobiliary drainage, according to indications. Efficacy of the abscess cavity sanation, using miramistinum and decasan, was proved. In general therapy the directed transport of medicines was applied.

Adolescent↗
PubMed2004

[Dynamics in the local and systemic immune factors in patients with cystic transformation of the bile duct].

Cystic transformation of biliary ducts (CTBD) is a rare inborn anomaly of the biliary system development. For the patients with CTBD quite high metabolic activity of neutrophils according to data of spontaneous test with nitroblue tetrazolium (NBT-test), reduction of IgA content in the initial period, significant raising of interleukin-6 (IL-6) level on the first postoperative day are characteristic. Quantity of active neutrophils of type II in the blood of patients with CTBD depends on antigenic load. Neutrophils in the bile restore the NBT according to type I. Local concentration of IL-6 and IL-8, and also the functional activity of neutrophils in ductal bile in patients with CTBD are the sensitive indexes of clinical state and immunological reactivity.

Adolescent↗
PubMed2002

[Interleukin-6 content in the blood serum and bile duct in patients with obturative jaundice of different origin].

There were examined 19 patients with nontumoral disease and 13--with hepatopancreatoduodenal zone organs tumor. In nontumoral disease interleukin-6 (IL-6) was revealed in 83.3% of patients in the blood serum and in 88.9%--in ductal bile; in nontumoral impassability of biliary ducts IL-6 was revealed in the blood serum in 53.8% of patients, in ductal bile--in 87.5%. It was established, that bilirubinemia degree did not correlate with IL-6 content in the blood serum, but was directly influenced by its concentration in ductal bile.

Adult↗
PubMed2001

[Injury of biliary ducts in laparoscopic cholecystectomy].

Peculiarities of the biliary ducts (BD) damage while performance of laparoscopic cholecystectomy (LCHE) and their significance in the choice of the operative correction method were studied up. In 35 patients the kinds and mechanisms of BD damage were analyzed. Taking into account large and small injuries, the general frequency of BD trauma while performance of LCHE had constituted 0.11%, what is comparable with indexes, characteristic for open cholecystectomy. Electric burn of BD wall, isolated one or in conjunction with other kinds of trauma, were observed in 15 (42.8%) of patients. Miniinvasive interventions, including those using laparoscopic access, are effective in treatment of small and some kinds of partial injuries. The operation of choice in correction of BD damage is formation of high hepaticojejunoanastomosis, when diagnosis is established intraoperatively or was postponed.

Adult↗
PubMed2001

[Diagnosis and treatment of cystic transformation of biliary ducts].

Experience of surgical treatment of 58 patients with cystic transformation of biliary ducts of various type was presented. There were adduced tactics of examination of the patients, kinds of operative treatment, postoperative complications were analyzed. In 33 patients there was performed resection of cystically-changed common biliary duct and subsequent formation of hepaticojejunoanastomosis with the jejunal loop, excluded according to Roux method. Late results of treatment of patients were studied. Malignization in cystic wall was revealed in 2 (3.4%) of patients. One patient died.

Adolescent↗
PubMed2001

[Lessons on laparoscopic cholecystectomy (summary of the experience].

The experience of laparoscopic cholecystectomy conduction in 6524 patients with nontumoral diseases of gallbladder (chronic calculous cholecystitis, an acute calculous cholecystitis, chronic noncalculous cholecystitis, the gallbladder polyposis) was summarized. While comparing the initial seizing experience in laparoscopic cholecystectomy in the clinic the tendency was noted, trusting the skills improvement in management of laparoscopic technique, permitting to reduce the contraindications quantity for laparoscopic cholecystectomy. Several principles were elaborated, which is necessary to follow doing laparoscopic cholecystectomy for improvement of results of treatment in patients and for complications reduction.

Adolescent↗
PubMed2000

[Laparoscopic interventions on choledochus: 5 year experience].

Complex examination of 69 patients with complicated cholelithic disease was performed. The elaborated in the clinic algorithm for preoperative examination of the patients was applied to reveal the main bile ducts pathology. Indications for the laparoscopic interventions on choledochus performance were substantiated.

Adult↗
PubMed2000

[Diagnosis and surgical treatment of Mirizzi's syndrome].

Retrospective analysis was done concerning the course of cholelithic disease, the results of laboratory, ultrasonographic, radiological, endoscopical methods of investigation, conducted in 52 patients with different forms of Mirizzi syndrome. The method and extent of surgical correction of the disease are recommended.

Biliary Fistula↗
PubMed1999

[The use of high hepato-jejunostomy in the treatment of biliary ducts injury during cholecystectomy conduction].

The results of hepaticojejunostomy application for the biliary ducts (BD) damage while cholecystectomy conduction as a primary operation (in 35 patients) and as a reoperation (in 16) were analyzed. The basic principles of interventions were: forming of the high hepaticojejunostomy 2cm in width with longitudinal incision of the ductus choledochus anterior wall and the left or both lobar BD, depending on the level of damage; minimal mobilization of the BD medial wall for its devascularization prophylaxis; precisional interrupted one-layer suturing, using atraumatic monofilament threads; exclusion of the Roux-en-Y small bowel segment 70 cm in length. In all the patients the result of treatment was studied up in terms from 1 to 56 months. All the patients have had survived. Positive result was noted in 94.2% of them.

Adult↗
PubMed1999

[An approach to the right hepatic duct in treating high damage and cicatricial stricture of the bile ducts].

There was proposed an operative access to the duct via the lateral end of transverse hepatic fissura, basing on the results of studying of the right hepatic duct anatomy. The method performed includes the right hepatic lobe mobilization, its fibrous capsule transsection along the transverse fissura in the direction toward right posterior sectorial duct, longitudinal transsection of the duct lateral wall along 1-2 cm with subsequent formation of laterolateral hepaticojejunoanastomosis. Method was tested in 9 patients with high damage and cicatricial stricture of biliary ducts, the result was positive.

Adult↗