[A method of endoscopic papillosphincterotomy in peripapillary diverticula].
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Biomedical subjects
Publications and source records attributed to M D Semin.
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On the basis of the results of examination of 275 patients with high obstruction of the bile ducts of different genesis, it is shown, that ultrasound diagnosis permits correct establishment of the nature of jaundice in 96%, level of obstruction in 75.8% of cases. In use of combination of the direct methods of ante- and retrograde cholangiography and sonography, the precise diagnosis permits to determine the possible volume of operative intervention.
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Experience obtained from operations on 2,458 patients for benign stenosis of Vater's papilla provided a background against which a classification was made of this pathological pattern. Preoperative and intraoperative diagnostic methods and surgical techniques are discussed and are critically appraised. Endoscopic papillospincterotomy had been introduced to clinical practice in 1979 and has ever since been the optional surgical approach to Vater's papilla. Differentiated attitudes to various possible corrections of benign stenosis together with high technical standards in surgery proper have so far yielded good long-term results for 89 per cent of patients.
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An experience with the treatment of 83 patients with recurrent jaundice or jaundice developed after operations on the liver, extrahepatic bile ducts and gallbladder was used by the authors for an analysis of causes of the appearance of jaundice, diagnosis and treatment of such patients. Indications for relaparotomy were restricted due to using retrograde cholangiography and endoscopic papillotomy.
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The authors observed 146 patients with pancreatic cysts. Operations were performed on 119 patients. Pancreatic cysts were diagnozed by a complex method of examination including retrograde endoscopic pancreatography, ultrasonic echography and selective angiography. The use of the complex method gave high diagnostic results--97.2%.
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