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Biomedical subjects

P M Postolov

Publications and source records attributed to P M Postolov.

At least 19 recordsLinked to original sources
PubMed1991

[Errors in ultrasonic diagnosis of abdominal diseases].

Errors in the ultrasonic diagnosis of diseases of the abdominal organs in 2,218 patients were analysed in comparison to endoscopic and operative findings. The errors were few in number. A precise diagnosis was established in 99.6% of cases with acute cholecystitis and in 78% of those with a pathological process in the biliary tract. A maximum number of errors (7 per 42 cases) was encountered in carcinoma of the gallbladder. Ultrasonic examination may serve as the basis for choosing the method of rational therapy in diseases of the liver, pancreas, and complications in the postoperative period. Thus, the results of ultrasonic examination may be fully relied on or may be used as a basis for choosing manipulations which are more invasive in character.

Abscess↗
PubMed1991

[Therapeutic tactics after laparoscopic cholecystostomy in patients with acute cholecystitis].

Laparoscopic cholecystostomy was undertaken in 178 elderly and old-aged patients with acute cholecystitis. Dynamic cholecystoscopy with biopsy of the cystic mucosa and bacteriologic study of the bile was conducted for objective appraisal of the inflammatory process in the gallbladder. Concluding operations on the bile tract were carried out in 147 patients. New methods were applied in 10 patients: filling of the gallbladder and contact solution of the stones in the gallbladder and bile ducts.

Acute Disease↗
PubMed1991

[Contact dissolution of gallstones].

The techniques and results of contact dissolution of stones in the gallbladder of 27 patients subjected to laparoscopic cholecystostomy for acute cholecystitis were analysed. It was found that the main factors impeding effective dissolution were: the size of the stones over 1.5 cm and admixture of pigment in the concrements. The first Soviet produced litholytic preparation Oktalgin, synthesized by the authors jointly with the Zelinsky IOCh, AMS USSR, was used as the main solvent. The principal possibility of dissolving multiple stones of the gallbladder through laparoscopic cholecystostomy is proved.

Acute Disease↗
PubMed1991

[Is selective proximal vagotomy expedient in the treatment of bleeding duodenal ulcers?].

The article analyses the results of truncal and selective proximal vagotomy with gastric draining operations in 101 patients with bleeding duodenal ulcer. The patients' condition, the results of special methods of examination, and the morphological changes in the gastric mucosa were studied. It was found that selective proximal vagotomy with drainage of the stomach had no advantages over truncal vagotomy. Besides, being a technically more difficult operation than truncal vagotomy, it fails to meet the requirements of emergency surgery and its application in patients with a bleeding duodenal ulcer isnot expedient.

Contraindications↗
PubMed1991

[Study of crystal structures of the bile in the diagnosis of gallstone composition and prognostication of the possibilities of their dissolution].

Bile was studied by polarizing microscopy and gallstones by infrared spectroscopy in 150 patients with cholelithiasis. It was established that the presence or absence of certain hard crystal structures in bile, determined by polarizing microscopy, reflects with sufficient accuracy the chemical composition of gallstones in patients with cholelithiasis. The high degree of correlation of the prognosticated result of litholysis on the basis of polarizing microscopy and the results of gallstone dissolution in experiments shows that the information gained in polarizing microscopy may be used as one of the most important criteria in determining the indications and contraindications for dissolving gallstones with octagline.

Adolescent↗
PubMed1990

[Study of crystalline structures of the bile in the diagnosis of cholelithiasis].

Under analysis were results of polarization microscopy of bile in 111 patients with cholelithiasis, 8 patients with acalculous cholecystitis and 8 practically healthy people. It was found that in healthy people there are no crystalline structures in the initial state of bile. The composition of bile from patients with cholelithiasis is characterized by the presence of three types of crystals: solid crystals of cholesterol monohydrate, calcium bilirubinate granules and calcium carbonate microspherolites. Polarization microscopy of bile may be used as a sufficiently simple method of diagnostics of stone disease.

Adult↗
PubMed1990

[A method of individual selection of cholelitholytic drugs for the treatment of cholelithiasis].

A method of individual selection of cholelitholytic agents was developed and tested in the clinic on the grounds of the findings of polarizing microscopy of bile and the results of study of gallstones by scanning electron microscopy. Its essence consists in visual appraisal of the effect of various solvents, used in the clinic, on the crystal structures of the patient's bile. The use of the developed method makes it possible to raise significantly the efficacy of contact solution of gallstones in combined treatment of cholelithiasis.

Aged↗
PubMed1990

[Special methods of examination in the diagnosis of cholelithiasis].

Rational combination of special methods of examination yields exact, objective, and detailed information for the diagnosis of cholelithiasis. Ultrasonic examination (USE) is an absolutely noninvasive method and therefore precedes all the other methods. USE suffices for the diagnosis of uncomplicated calculous cholecystitis. USE and intravenous cholegraphy are indicated in complicated cholecystitis without jaundice, USE and percutaneous transhepatic cholegraphy--in the presence of jaundice. These methods of examination are supplemented with endoscopic retrograde cholangiopancreatography in cases which are difficult for differential diagnosis and in those with cicatricial strictures of the bile ducts. Laparoscopy and aspiration biopsy of the liver usually complete the examination. In emergencies diagnostic laparoscopy, despite its definite invasive character, is conducted after USE.

Cholangiopancreatography, Endoscopic Retrograde↗
PubMed1990

[Ultrasonic semeiotics and diagnosis of acute cholecystitis].

From analysis of the results of ultrasonic examination in 1,428 patients with acute cholecystitis the authors determined the semeiotics of various forms and complications of the disease. The most common ultrasonic sign of acute cholecystitis is a triad of symptoms: enlarged gallbladder, thickened walls, and fixed hyperchostructures with an acoustic shadow in the projection of the neck of the gallbladder. Ultrasonic examination allows the presence of destructive cholecystitis to be detected with high precision on basis of the sign of a double gallbladder contour. Complications like pericystic infiltration, pericystic abscess with or without perforation, empyema of the gallbladder, acute pancreatitis, and choledocholithiasis can also be recognized in patients with acute cholecystitis by ultrasonic examination. Comparison of the data of ultrasonic examination with those obtained in laparoscopy or operation showed that the diagnosis coincided in 98.9% of cases.

Acute Disease↗
PubMed1989

[Direct cholecystography after laparoscopic cholecystostomy in acute cholecystitis].

Direct cholegraphy was performed after laparoscopic cholecystostomy in 82 patients. It should be conducted on the operating table if proper fixation of the draining tube is doubtful, but, mainly, on the fourth or fifth postoperative day. Double contrasting of the biliary tract with air and a contrast medium produces the best result.

Acute Disease↗
PubMed1989

[Dissolution of residual biliary calculi in early postoperative periods].

The agent Octaglin was used for dissolving residual stones found in 5 patients in the early periods after operations on the biliary tract. It was administered through a drain left in the choledochus or cystic duct during the surgical intervention. The composition of the concrements was determined from examination of the biliary crystal structures by the method of polarizing light microscopy. The stones were dissolved completely in all cases so that 4 of the 5 patients did not need to be operated on for a second time.

Adult↗