Biomedical subjects
Publications and source records attributed to D V Usov.
The authors share their experience with splenectomy, spleen artery ligation and its roentgen embolization in 110 patients with liver cirrhosis. Advantages of embolization ++ under roentgenological control are proved for the correction of hypersplenism, in preparing the patients to operations on the liver with using the methods of stimulation of reparative regeneration.
Variants and results of the surgical treatment of 50 patients are presented. In 25 of them the pathology of the pancreas was due to the altered function of the major duodenal papilla, 19 patients had dysfunction of the duodenum and in 6 cases only it was of primary character. Transplantation of the common bile duct was performed in papillopancreatitis, in duodenopancreatitis--the duodenum was by-passed for the food passage.
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The authors share their experience with the treatment of 18 patients. Most of them (10) sought medical aid for complications. The authors consider resection of the stomach to be ineffective for the exclusion of the diverticulum of the duodenum. The operation of choice is thought by them to be an exclusion of the duodenum from the passage of food. Stomach resection after Ridiger is thought to be effective for a combination of the diverticulum and duodenal ulcer. There were no complications or immediate lethal outcomes.
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On the basis of a great clinical material the authors make an analysis of typical errors in the surgical treatment of inguinal hernias. The main of them was the absence of an individual approach to choice of the operative method. Strengthening of only the frontal wall of the inguinal canal is one of the causes of recurrences.
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On the basis of the experience with the treatment of 100 patients with the ruptured spleen (in 44 of them the injury was associated with injuries of other organs of the abdominal cavity, skeleton bones or cranio-cerebral traumas) the authors recommend to use organ-preserving operations more often (in 42-46% of the patients). A technique of one of the operations--a compression ("hammering") of the spleen by a peritoneum grafts--is described.
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Literature data on 294 patients with injuries of the duodenum and 24 personal observations were analyzed in order to reveal the localization and character of the injuries, surgical interventions, complications and outcomes of damages of this organ. Injuries of the duodenum, especially of its retroperitoneal portions, were found to be more frequent. Reserves for improving results of the treatment were shown to be in better diagnosing and performing operations with minimum amount of anastomoses, careful drainage of the retroperitoneal space, aspiration of the gastro-intestinal content.