[Insuloma: problem of timely diagnosis].
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Diagnosis, Differential↗
Biomedical subjects
I M Shevchuk
Publications and source records attributed to I M Shevchuk.
[Modern strategies in surgical treatment of acute necrotic pancreatitis].
The experience of surgical treatment of acute necrotic pancreatitis (ANP) in 172 patients in 1997-2002 were summarized. We started therapy from conservative treatment. In 43 (25%) patients with ANP video laparoscopic intervention in enzyme-toxic period were performed. In 32 of them we avoided laparotomy. Percutaneous intervention under the control of ultrasound imaging was conducted in 130 (75.6%) patients. This procedure was final in 81 patients, 58 (33.7%)--underwent laparotomy, in 42 of them concerning ANP. Postoperative mortality was 11.1%. Individual approach, strict following the tactics chosen, wide use of miniinvasive techniques in deferred period when necessary, laparotomy ensures significant progress in the treatment of ANP.
Algorithms↗
[Dynamic biliary manometry: display modelling and graphic interpretation].
Tendencies of development of biliary manometry have been analyzed. Key advantages and problems of manometric investigation of biliary tracts have been summarized. New method of graphic registration and pressure monitoring in biliary tracts called biliary manometry has been suggested. Characteristic types of manometric curves were determined using stand modelling, their physical and mathematical analysis was conducted, clinical analogues have been suggested. The emphasis has been made on expediency of its further elaboration and clinical application.
Bile Duct Diseases↗
[Minimally invasive interventions for concurrent diseases of extrahepatic biliary ducts and pancreas].
The results of treatment of 689 patients with calculous cholecystitis and of 12 with cholecystogenic acute pancreatitis (AP), to whom laparoscopic interventions were performed, are adduced. In 50 patients the indexes of operative stress were studied up. The laparoscopic cholecystectomy efficacy was established in patients with cholecystogenic AP in the absence of obturational jaundice.
Acute Disease↗
[Possibilities of transcutaneous intervention under ultrasonographic control in comprehensive treatment of severe necrotizing pancreatitis].
In 46 patients with an destructive acute pancreatitis (AP) the invasive intervention under control of ultrasonography, in 38 of them--in stage of purulent complications, was performed. It had promoted stabilization of state in 39 (89.8%) patients, normalization of clinic--laboratory indexes, that had permitted to realize radical operative intervention with minimum risk in perspective. Invasive intervention under control of ultrasonography--highly effective primary surgical manipulation in complex of treatment of the destructive AP severe forms.
Aged↗
[Diagnosis of the pancreonecrosis using the gas chromatography method].
In 62 patients with various forms of an acute pancreatitis (AP) the contents of methane, oxygen, nitrogen, carbon dioxide gas in the blood, using the gas chromatography method, was studied up. In 55 patients with pancreonecrosis the changes of concentration of methane, oxygen and nitrogen had correlated with the disease course severity, the data of ultrasound investigation and bolus computer tomography. Basing on the investigations performed in 62 patients with an AP, in 12--with other acute surgical diseases of abdominal cavity and in 20 healthy persons, it was established the possibility of determination of the methane level in the blood as a criterion of the various forms of pancreonecrosis diagnosis and the method of its diagnosis was proposed.
Adult↗
[Surgical treatment of an acute destructive pancreatitis using laparoscopy and peritoneal dialysis].
Laparoscopic intervention was performed in early stages of acute destructive pancreatitis in 34 patients. In 23 patients after draining of the abdominal cavity the laparoscopic intermitting peritoneal dialysis with application of the "Gambro" firm solutions during 2-4 days was done. Efficacy of the proposed method of detoxication in complex treatment of patients was established.
Adult↗
[Computer and ultrasonic diagnosis of destructive pancreatitis].
During investigation of 118 patients with destructive pancreatitis using ultrasonographic investigation and computeric tomography the signs of pancreonecrosis and retroperitoneal phlegmon were revealed correlating with origination of methane and enhancement of its concentration in blood, trusting the pancreatic tissue structural and functional insufficiency occurrence.
Adult↗
[Surgical treatment of an acute pancreatitis].
The results of surgical treatment of 107 patients with an acute pancreatitis for 1990-1998 period were analysed. The miniinvasive methods application, directed on the aseptic pancreatic necrosis transition to purulent pancreatitis prophylaxis and timely conduction of operative intervention for purulent pancreatitis, have permitted to lower postoperative mortality from 26 to 10.5%.
Adolescent↗
[Combined intensive therapy and anesthesiological support for a surgical intervention in patients with necrotic pancreatitis].
The results of surgical treatment of 93 patients with necrotic pancreatitis are adduced. Of 71 patients, operated on using laparotomy, 18 (25.3%) have died, of 22 patients, in whom the laparoscopy (LS) was used, 1 (4.5%) have died. In 17 patients the laparotomy was omitted due to combination of LS with complex conservative treatment. Of 44 patients operated on 3 (6.8%) have died during the period of the improved tactics introduction.
Adult↗
[Complex surgical tactics in the treatment of patients with necrotic pancreatitis].
The results of treatment of 47 patients with an acute pancreatitis including 40 with necrotic pancreatitis are adduced. Of 34 (72.3%) patients operated there were 4 with pancreatic gland oedema. Laparoscopic intervention in 24-48 hours after the illness beginning was conducted in 21 (44.7%) patients, in concomitance with peritoneal dialysis--in 11, laparoscopic cholecystectomy--in 6. In 20 patients the abortive course of necrotic pancreatitis and the laparotomy conduction avoidance were achieved. Postoperative lethality was 8.8%.
Adolescent↗
[Clinical variants in the course of a postoperative bleeding stress ulcer].
The results of treatment of 13,246 patients with acute surgical disease of the abdominal organs have been analysed. In 48 patients, bleeding from a stress ulcer occurred. The symptoms of bleeding were studied. The variants of the clinical course of postoperative acute erosion and ulcer, such as the lightning-like, double-phase, single-phase ones, have been distinguished. Their predictive value is shown. In 89.6% of the patients, a postoperative stress ulcer developed in diseases of the hepatopancreatobiliary zone organs.
Acute Disease↗
[Prevention and treatment of stress-induced ulcers].
The data presented show that along with acid-peptic aggression an important role in pathogenesis of stress ulceration in the stomach and duodenum belongs to energy and immune deficiency which makes the correction of these alterations necessary. The timely and valuable conservative therapy including histamine H2-receptor blocking agents in addition to antacids and endoscopic electrocoagulation in case of profuse bleeding from stress ulcers allows to obtain hemostasis and healing of the ulcers more than in 90% of cases. When choosing the surgical method of treatment the preference should be given to atraumatic organ-preserving operations.
Abdomen, Acute↗
[Effect of peritol on gastric secretory function].
Peritol produces a marked inhibiting effect on the gastric secretory function in dogs with fistulas of the stomach and duodenum stimulated by insulin and carbacholin while the influence on the pentagastrin gastric secretion was weaker. In its effect on the histamine secretion peritol inhibits only the secreted juice pepsin. The practical importance of the above for clinical gastroenterology is suggested.
Animals↗
[Effects of serotonin and stress on the state of the gastric mucosa in rats with the intact and transsected vagus nerve].
In experiments on vagotomized and intact rats with the use of two models of experimental gastric ulceration (injection of serotonin and stress) it was demonstrated that the inhibitory action of vagotomy on haemorrhagic gastric effectiveness was more pronounced in stress than after serotonin application. Vagotomy decreased stress-induced erosive lesions but increased serotonin-induced erosions that may be a result of the increase of gastric tissue sensitivity to this amine which developed simultaneously with significant decrease of its level in gastric wall after vagotomy. Serotonin-antagonist peritol decreased stress-induced gastric disturbances in vagotomized rats more significantly than in intact rats; this suggested the great role of serotonin in anti-ulcerogenic effect of vagotomy.
Animals↗
[Prevention of acute erosions and ulcers of the esophagus, stomach and duodenum after surgery].
The authors have established that after different operations acute erosions and ulcers of digestive organs which are often complicated by bleedings and perforations arise in 67% of the patients. The method of complex prophylactics developed by the authors includes general measures (a rational preparation to the operation, adequate anesthesia, sparing method of operating, active management in the postoperative period) and special ones (the administration of cerucal, anabolic steroids, methyluracil and almagel). This method makes the amount of erosive-ulcerous affections 12-15 times less and practically prevents complications.
Acute Disease↗
[Peritoneal dialysis in the treatment of chronic renal failure].
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Humans↗