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Biomedical subjects

I V Khomiak

Publications and source records attributed to I V Khomiak.

At least 19 recordsLinked to original sources
PubMed2006

[Effect of cerulloplasmin on natural factors of defense in patients with an acute necrotic pancreatitis].

In 81.25% patients with an acute necrotic pancreatitis and in 50% of healthy persons the blood neutrophils are sensitive to cerulloplasmin in metabolic activity. In 62.5% of patients the phagocytic index have had reduced in addition of cerulloplasmin. Phagocytic number in addition of cerulloplasmin have constituted over 1,5 conditional units, in 75% of patients, without such addition - in 84%. The conclusion was made about necessity of individual selection of immunomodulators in patients with an acute necrotic pancreatitis.

Adult↗
PubMed2006

[Preoperative biliary decompression in patients with malignant tumor of duodenal major papilla].

Experience of surgical treatment of 241 patients with malignant tumor of duodenal major papilla in 1992-2005 yrs was analyzed. In 95 patients the treatment was conducted in two stages, the first of which have had included biliary decompression. There were analyzed 18 potential risk factors for postoperative complications occurrence. Preoperative biliary decompression conduction have had constituted one of the risk factors for postoperative complications occurrence. There were proposed strict recommendations concerning preoperative biliary decompression conduction in patients with malignant tumor of duodenal major papilla.

Adult↗
PubMed2005

[Main principles of antibiotic prophylaxis and antibacterial therapy in abdominal surgery].

The principles of antibioticoprophylaxis and antibacterial therapy in abdominal surgery were expounded. There are adduced the most frequently revealed pathogenic microorganisms, inducing intraabdominal infection, the ways of lowering of the antibacterial therapy expenses, new approaches to application of immunocorrection and directed transport of antibiotics in surgery as well as empirical and etiotropic treatment, basing on the taking account of the spread and antibioticosensitivity of pathogenic microorganisms of nosocomial infections. There was shown, that concentration of interleucin-1beta and tumor necrosis factor-alpha in the blood serum is connected with the severity of patient state. Significant rising of this cytokines concentration constitutes the trustworthy criterion of the ineffective therapy and mortality risk. The influence of microorganisms and some antibiotics on induction of interferons was studied. Amoxicyllin, polymixin, vancomycin, cephalosporins and fluconazol are the most active inductors of gamma-interferon. Maximal efficacy of antibacterial therapy is possible only if an adequate surgical intervention was performed.

Abdominal Cavity↗
PubMed2005

[An acute necrotic pancreatitis as a complication of cystic pancreatic tumor].

The peculiarities of the cystic pancreatic tumor morphogenesis were studied up. Possibility and probability of the anastomosis existence between mucinous cystic tumor and pancreatic duct with its secondary mucinous dilatation were confirmed, causing the complications occurrence, an acute pancreatitis in particular. Selecting the surgical tactic in mucinous cystic tumor it is necessary to take into account the probability of the intraductal malignization foci formation, what precludes application of extended pancreatic resection using adjuvant chemotherapy and the postoperative serological control conduction.

Aged↗
PubMed2004

[The application efficacy of immunomodulators in complex of treatment of an acute necrotic pancreatitis].

Analysis of efficacy of the immunomodulators application, thymalin in particular, in complex treatment algorhythm in 18 patients with an acute necrotic pancreatitis was conducted. Efficacy of immunocorrecting therapy in the immune state improvement, purulent-septic complications prophylaxis, the abortive course of the disease promotion was established In 12 (66.7) patients the disease regression was noted, in 2 (11.1%)--the inflammatory process delineation with pancreatic pseudocyst formation was observed, 4 (22.2%) patients were operated on. All the patients survived.

Adjuvants, Immunologic↗
PubMed2003

[Use of compressive biliary-digestive anastomoses in surgical treatment of chronic pancreatitis complicated by biliary hypertension and obstructive jaundice].

For the 1996-2000 yrs period 47 patients with complicated forms of chronic pancreatitis and signs of obturation jaundice were operated on in the clinic. In 23 (49%) patients the intervention on biliary ducts was performed: in 4 (8.5%)--hepaticojejunoanastomosis was formatted, in 3 (6.4%)--cholecystoenterostomy was done, in 2 (4.3%)--pancreatoduodenal resection and in 14 (29.8%)--supraduodenal choledochoduodenostomy were performed. Compression device was used while performing biliodigestive anastomosis in 6 (12.8%) patients. Application of the elaborated method of the compression biliodigestive anastomosis formation have permitted to reduce the operative intervention duration, to lower the postoperative complications occurrence and to improve the late follow-up result.

Bile Ducts↗
PubMed2003

[Pancreatic-jejuno-duodenostomy by a small isolated intestinal segment: the function-preserving surgery for complicated forms of chronic pancreatitis].

Results of treatment of 26 patients with calcinous fibrous-degenerative chronic pancreatitis, operated in clinic in 2001-2002 years, were analyzed. Standard method, using longitudinal pancreatojejunostomy on excluded loop of small intestine according to Roux, was performed in 12 patients (first group). In 14 (second group) operation of pancreatojejunoduodenostomy was performed, using isolated segment of small intestine according to method proposed by the authors. Data of comparative analysis performed, witness, that during performance of pancreatojejunoduodenoanastomosis in all patients with disappearance of main pathological symptoms of disease the significant improvement of lipid and protein metabolism occurs in comparison with such in patients of control group.

Adult↗
PubMed2003

[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↗
PubMed2002

[The application of laferon in a combined therapy of purulent cholangitis].

Results of treatment of 160 patients, operated on for nontumoral biliary ducts impassibility, complicated by purulent cholangitis, were analyzed. In 60 patients intraoperatively and after the operation in complex of treatment laferon solution was injected into biliary ducts in dosage 500,000--1 million IU a day, permitting to reduce the frequency of the postoperative complications occurrence from 62.2 to 36% and of postoperative mortality--from 13 to 6%. Regional immune therapy using laferon stimulates the factors of organism inflammatory reaction and hepatocytes functional state restoration.

Cholangitis↗
PubMed2001

[Cholecystectomy by mini-laparotomy access. Retrospective analysis of the 10-year work].

Ten-year experience of operative treatment of cholelithic disease using mini-access cholecystectomy (MACH) in 920 patients was summarized. There were operated on 167 patients for an acute cholecystitis, chronic calculous cholecystitis--716, gall bladder polyposis--36, gall bladder cancer--1. In 48 patients the MACH was matched with choledochus drainage, in 9--choledocholithotomy was performed, in 1--choledochoduodenostomy. In 6 observations the MACH were done simultaneously inguinal herniotomy, in 10--umbilical herniotomy, in 7--uterine extirpation, in 13--operation for ovarial cyst. The bile leakage from gall bladder bed occurred in 3 observations, the operative wound suppuration--in 4. Duration of stationary treatment was 4.1 days at average.

Adolescent↗
PubMed2001

[Clinical signs, diagnosis and surgical treatment of extrahepatic biliary duct tumors].

Experience of surgical treatment of 271 patients the extrahepatic biliary ducts tumor for the 1992-1999 yrs period is presented. Indirect signs of extrahepatic biliary ducts tumor were revealed in 84% of observations. Depending on the tumor localization the trustworthiness of the endoscopic retrograde pancreatocholangiography method had constituted from 79.8 to 96.4%. Correct diagnosis was established before the operation in 94.3% of patients. Radical operation was done in 93 (34.3%) of patients, including 22 with proximal localization of tumor, 13--with central one, 10--distal, 48--terminal. Palliative operation was performed in 178 patients, in 76 of them biliodigestive anastomosis was done. Total postoperative mortality was 14.8%.

Adult↗
PubMed2000

[Surgical strategies in the treatment of complicated forms of chronic pancreatitis].

For the period from 1992 to 1998 years 554 patients with complicated chronic pancreatitis were operated on. In 248 patients the longitudinal pancreatojejunostomy was performed, in 113--pancreatojejunostomy in 75--external drainage of the cyst, of them in 12--under the ultrasonic investigation control. In 21 patients pancreatoduodenal resection was conducted, pancreatic gland (PG) distal resection--in 41. In 4 patients with the PG head calcinosis the pancreatic resection according to Beger was done, in 3--the Frey operation. In the total PG calcinosis in 9 patients the modified Frey's operation was performed in conjunction with platitude PG resection along posterior wall of her duct. The indirect operation on PG were done in 40 patients. Nine (1.6%) of patients died.

Adult↗
PubMed1999

[Compression biliodigestive anastomosis: the morphological characteristics of its dynamics of formation].

The method of the compressive biliodigestive anastomosis formation, using implant and the apparatus for its performance, was elaborated. An experimental investigation on 30 rabbits was done. An optimal strength of compression while doing the tissues connection was 0.002-0.004 N/m2. Minimal traumaticity, preservation of sufficient blood flow of the tissues connected, delineation of the healing zone from the intestinal contents and bile, the absence of chronic inflammation in anastomotic tissues are the advantages of compressive biliodigestive anastomosis, promoting early restoration of the intestinal and gallbladder wall, the formation of functionally full value anastomosis, which is not stenotizes cicatricially.

Anastomosis, Surgical↗
PubMed1998

[The diagnosis and surgical treatment of complicated forms of chronic pancreatitis].

The experience of surgical treatment of 517 patients with complicated forms of chronic pancreatitis (CP) was analyzed. In patients with the fibrotic CP without ductal hypertension, while involvement in the process of neighboring organs, the operations were conducted for the biliary and duodenal impassability elimination. The drainage operations of various types are indicated in fibrotic CP with ductal hypertension. In patients with fibrotic-degenerative CP the resectional methods were applied. Postoperative mortality have constituted 1.9%. Good and fair result of treatment in the late follow-up period was achieved in 75.7% of patients due to application of the proposed differentiative tactics.

Adult↗