[Aneurysm of the splenic artery in liver cirrhosis and portal hypertension].
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Biomedical subjects
Publications and source records attributed to K A Tsybyrné.
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Cruveilhier--Baumgarten syndrome (CBS) was revealed in 6 of 35 patients with portal hypertension. Esophageal veins varicosis was revealed in 5 patients with CBS, in 4 of them the hemorrhage have occurred. The portal system encephalopathy was not observed. The peculiarities of blood flow in a portal vein system while CBS were studied according to data obtained by ultrasonic dopplerography. The authors do not recommend the umbilical vein usage while portocaval anastomosis forming.
A modified classification of complications of sclerotherapy of esophageal varices is presented.
Experience in the treatment of 129 patients with esophagogastric hemorrhage due to portal hypertension is discussed. An original modification of the design of Blakemore's tube is suggested, with the use of which the results of nonoperative treatment were improved and the mortality among this category of patients was reduced. Operation was performed on 75 patients. The total mortality among all hospitalized patients was 6.2%. The Tanner-Petrov operation was carried out on 55 patients, splenorenal anastomosis was formed in 6, organopexy was conducted on 4, splenectomy in combination with organopexy in 8, and portocaval anastomosis was formed in 2 patients. Three patients died after the operation.
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The peculiarities of one-stage echinococcotomy in 7 patients with multiple and combined bilateral echinococcosis of the lungs and liver are discussed. The operation is carried out by two surgical teams who work simultaneously except for the interval of time from the moment that the pleural cavity is opened to the removal of the pneumothorax, in which period the surgeons work in turns.
The authors generalize experience in experimental study of some surgical interventions in severe injuries to the liver. A total of 104 operations were carried out on 52 animals. The efficacy of gauze tamponade with the use of absorbable hemostatics is determined. The methods for applying a vascular suture in injury to the efferent hepatic veins was studied on 12 human cadavers and 10 dogs. It is concluded that gauze +hepatic tamponade is expedient, mainly in coagulopathy in which subsequent relaparotomy is necessary (optimal terms 1-3 days) and the accomplishment of final hemostasis.
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In 77 animals, 154 operations of gauze tamponade of a hepatic wound with the use of hemostatic preparations were performed. On the 12 human cadavers and 10 dogs, the technique of placing a vascular suture in injuries to efferent hepatic veins was tried. The dynamics of acid phosphatase activity as a criterium of hepatic cirrhosis involution after partial hepatectomy in 30 albino mice was traced. The use of gauze tamponade of a hepatic wound with the performance of relaparotomy (optimal time: within 1-3 days) and definitive hemostasis is expedient, mainly, in coagulopathy. No differences in the regression of hepatic cirrhosis in partial resection of the liver and without it were revealed.
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