Biomedical subjects
Publications and source records attributed to D E Klimov.
Laparoscopic resection of the stomach by Billroth-I technique is described. Previously different variants of laparoscopic Billroth-II resection and laparoscopy-assisted Billroth-I resection have been performed a complete variant of laparoscopic Billroth-I resection of the stomach the authors reported on Symposium of Endo-surgeons in 2004.
Minimally-invasive operations were used in 156 patients with acute appendicitis. Laparoscopic appendectomy with ligature method by F. Gotz was performed in 64 (41%) patients (group 1), combined appendectomy--in 32 (20.5%) patients (group 2), laparoscopic operation with ligature method in the authors modification in combination with developed prophylactic complex--in 60 (38.5%) patients (group 3). Conversion to open operation was necessary in 6 (3.8%) patients. Intraoperative complications were seen in 5.1% operated patients, postoperative--in 6.4%, however rate of complications in each group ranged from 10.9 to 1.7%. Results of bacterial examination during different stages of laparoscopic appendectomy are provided. Programme of postoperative complications prophylaxis is described. Algorithm of differential approach to various methods of laparoscopic or minimally-invasive appendectomy in presented.
Results of diagnostic laparoscopy in acute appendicitis suspects are presented. Laparoscopy allowed examination of the appendix in 96.5% cases, to make final diagnosis in 92.5% and to avoid surgery in 31.2% cases. Larger application of diagnostic laparoscopy in patients suspected of acute appendicitis will reduce significantly rate of diagnostic mistakes, complications and unwarranted appendectomies.
Laparoscopy and pancreatoscopy were performed in 2091 (62% of all hospitalized) patients with acute pancreatitis. High informative value of laparoscopy and pancreatoscopy in diagnosis of different morphologic forms of acute pancreatitis is demonstrated. Original fistula for pancreatoscopy was developed. It permits one to evaluate visually the dynamics of repair in the pancreas and surrounding tissues and to correct treatment policy.