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R M Agaev

Publications and source records attributed to R M Agaev.

8 recordsLinked to original sources
PubMed2006

[Treatment policy for postoperative complications in patients with hepatic echinococcosis and bile duct affection].

Results of surgical treatment of 277 patients with hepatic echinococcosis and bile duct affection demonstrated that the rate of specific postoperative complications depends on duration of the disease, location and size of the parasitic cyst, changes in the cyst (suppuration, calcification), and also on the level of the lesion in the bile ducts. They were seen in the lesion of the segmental ducts 1.5 times less (18%) often than in the lesion of the hepatic ducts (25.7%). Early diagnosis, adequate surgical treatment, characteristics of pathological alterations in the cyst and bile ducts influence treatment outcomes. Postoperative complications arose in 25.9% cases with lethality 1.4%. These complications were diagnosed 6 times less often after elimination of the residual cavity, suturing of bile fistulas or other methods (resection, pericyctectomy) application than after drainage of the residual cavity.

Adult↗
PubMed2005

[Surgical policy in echinococcosis of the liver with affection of bile ducts].

Short-term results of surgical treatment of 277 patients with hepatic echinococcosis associated with affection of bile ducts are analyzed. If it is impossible, additional drainage of bile ducts and residual cavity is indicated. Pericystectomy is recommended when hydatid cyst has calcified fibrous capsule. It is demonstrated that rational surgical policy permits to achieve favorable results: postoperative complications were seen in 25.9% cases, lethality was 1.4%.

Adolescent↗
PubMed2004

[Diagnosis of bile ducts lesions in echinococcosis of the liver].

The results of examination and surgical treatment of 277 patients with hepatic echinococcosis with bile ducts lesion are analyzed. Symptoms of bile ducts lesion serve the indication for direct roentgenocontrast methods of bile ducts examination (endoscopic retrograde pancreaticocholangiography, percutaneous transhepatic cholangiography, fistulography). Jaundice in anamnesis, dilatation of hepaticocholedoch, abundant outflow of bile from residual cavity after echinococcectomy require additional examinations during surgery (USE, cholangiography, chromatic reaction). Instant chromatic diagnosis of internal cystobiliary fistulas is highly informative, particularly in cases when complete revision and visualization of wall of residual cavity is impossible.

Adolescent↗
PubMed2003

[Surgical strategy for perforating typhoid ulcers].

The authors share their experiences with operative treatment for perforation of typhoid ulcers in 15 patients. The dissection of ulcerous infiltrate followed by simple suturing was fulfilled in 4 out of these patients against the background of diffuse purulent peritonitis. All the patients died. So, in order to reduce lethality in the following patients we either fulfilled resection of the gut within the limits of not involved tissues with ileostomy if the patient had diffuse purulent peritonitis or made primary interintestinal anastomosis in cases without it. In both cases a microirrigator was introduced in the small intestine mesentery for administration of antibiotics at the postoperative period. It allowed to make lethality lower.

Adolescent↗
PubMed2001

[Surgical treatment of hepatic echinococcosis and its complications].

Over 11 years 280 patients underwent surgery for hepatic echinococcosis. A complicated form of the disease was revealed in 151 (54%) patients. Suppuration of cyst was in 88 (31.4%) patients, perforation of cyst into biliary tract--in 87 (31.1%), compression of bile ducts by cyst with mechanical jaundice--in 5 (1.8%), perforation into abdominal cavity--in 2 (0.7%) and cyst's calcification--in 9 (3.2%). The diagnosis was based on clinical, objective and instrumental examinations. The most informative methods in diagnosis of hepatic echinococcosis were US (96.7%) and CT (100%). Radical operations were performed in 26 patients: pericystectomy--6, "ideal" echinococcectomy--11, resection of the liver--9. In true bursting of parasite's elements into biliary tract with mechanical jaundice and cholangitis, the correction of biliary tract's passability was carried out. Postoperative complications were revealed in 33.2% patients, in the most cases they were non-specific. Lethality was 1.7% (3 patients).

Adult↗
PubMed1990

[Surgical tactics in the treatment of acute cholecystitis with lesions of the bile ducts].

The authors analyse the results of treatment of 185 patients with acute cholecystitis coexisting with affection of the bile ducts. In view of the high risk of operative treatment, endoscopic papillosphincterotomy was undertaken as the first stage in 83 patients and was completed by nasobiliary drainage in 46 of them, in still another 12 patients decompression was accomplished by means of laparoscopic cholecystostomy . Surgical intervention was carried out in the second stage after the patients recovered from a grave condition and obstructive jaundice and intoxication caused by purulent cholangitis were corrected. Another 90 patients underwent surgical operation without preliminary decompression in a postponed order (67 patients) and for emergency and urgent indications (19 patients) in vital conditions due to peritoneal phenomena. The changes in the bile ducts were corrected in them in the second stage, which reduced the risk of the development of postoperative complications. The authors emphasize the importance of two-stage treatment in coexistence of lesions and of a differential approach to the treatment of this contingent of patients according to the character and severity of the inflammatory process and the severity of the patients' condition.

Acute Disease↗
PubMed1989

[Endoscopic papillosphincterotomy in patients with acute cholecystitis and lesions of the common bile duct].

The authors analyse treatment of 115 patients who were admitted for acute cholecystitis with involvement of the bile ducts which manifested itself as a rule, as obstructive jaundice and cholangitis. Endoscopic papillosphincterotomy (EPST) was conducted as the first stage of treatment in 83 patients, as the second stage after cholecystectomy or laparoscopic cholecystotomy in 30, and during the surgical intervention in 2 patients. Experience shows that treatment of this contingent of patients in two stages is advisable. In emergency operations for acute cholecystitis, when the revealed abnormalities in the hepaticocholedochus cannot be corrected adequately due to the patient's severe condition or marked inflammatory changes in the region of the hepatoduodenal ligament, the operation should be completed by drainage of the common bile duct and antegrade or retrograde EPST should be performed in the post-operative period. In the presence of obstructive jaundice and acute suppurative cholangitis, when there is a high operative risk, EPST should be undertaken as an emergency intervention ensuring timely decompression and cleansing of the bile ducts. In 37.3% of patients EPST was conducted by an atypical method due to the high operative risk, as a result the efficacy of the endoscopic operation increased to 93.3%.

Acute Disease↗