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Biomedical subjects

V M Kopchak

Publications and source records attributed to V M Kopchak.

At least 19 recordsLinked to original sources
PubMed2006

[Peculiarities of diagnosis and surgical tactics in cystic pancreatic tumours].

Results of selective analysis of examination and operative treatment data in patients with clinical diagnosis of cystic pancreatic tumour for ten-year period were presented. The causes of diagnostic and tactic mistakes were analyzed. The volume of necessary methods of instrumental and laboratory diagnosis, indications for operative treatment, volume of which depends on the tumour morphological characteristic, were determined. In serous cystadenoma the tumour excision or economic pancreatic resection is indicated; in mucinous tumour the extended pancreatic resection is indicated.

Adult↗
PubMed2006

[Modern possibilities of chemotherapy in patients with ductal pancreatic adenocarcinoma].

Experience of application of preparation Gemzar as a chemotherapy agent for ductal pancreatic adenocarcinoma was analysed. In 28 patients (main group) chemotherapy using Gemzar preparation was conducted, in 30 patients (control group) chemotherapy was not conducted. The trustworthy differences of life span in patients with unresectable tumors in the main and control groups were noted. Difference of the patients life span after performance of radical pancreatic resection was not trustworthy.

Antimetabolites, Antineoplastic↗
PubMed2006

[Radical surgical treatment of cancer of periampullar zone organs].

Experience of treatment was analyzed of 862 patients with cancer of periampullar zone organs, to whom radical tumoral excision was performed in 1972-2005 yrs. Performance of radical operative intervention have permitted to achieve satisfactory late results in patients with tumor of duodenal major papilla and distal part of common biliary duct. Last years better immediate results of operative treatment were achieved due to postoperative mortality lowering.

Adenocarcinoma↗
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↗
PubMed2006

[The splanchnic blood flow indices in the patients, suffering external pancreatic fistula, and their dynamics under the influence of sandostatin and somatulin according to the ultrasonographic duplex scanning data].

Hemodynamical effects of the somatostatin analogues were studied in the patients with external pancreatic fistula. There were examined 29 patients, using ultrasonographic duplex scanning, for investigation of the blood flow indices in a. mesenterica superior, truncus coeliacus and its branches, v. lienalis, v. portae and pancreatic intraorgan arteries. Initial indices of splanchnic blood flow were compared with such while administration of octreotide. The main splanchnic blood flow indices in patients, suffering external pancreatic fistula, did not differ from that in controls, the lowering of the pulsation and resistance indices was noted as well as enhancement of the vessels quantity in pancreatic surgical margin. Under the influence of somatostatin the quantity of visualized vessels had reduced, the pulsation and resistance indices increased, the blood flow velocity along a. mesenterica superior, a. lienalis and pancreatic intraorgan arteries lowered, causing reduction of the blood flow linear and volumetric velocity along v. mesenterica superior and vv. intrapancreatici. Inhibitory action of the preparation on splanchnic blood flow was maximal in terms from 6 till 24 h after its infusion and had lowered step by step during all the follow-up period.

Adult↗
PubMed2005

[Application of modified frey operation for reduction of the autoimmune aggression severity to pancreatic tissues in patients with fibrous-degenerative pancreatitis].

Investigation of antibodies to the DNA-topoisomerase-1, the marker for autoimmune process in the blood serum, was conducted in 22 patients with chronic fibrous-degenerative pancreatitis, operated on in the clinic. The trustworthy raising of the antibodies titer in comparison with such in healthy donors was noted. In comparative analysis of the index in patients before and after the operation it was established, that in 12 of them after the standard draining operation it did not change within up to 12 months, in 10 patients, after Frey operation, performed in our modification, it had lowered almost twice.

Autoantibodies↗
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

[Morphological characteristics of cystic pancreatic tumors].

The results of 86 clinical observations of cystic pancreatic tumor are adduced. The expediency of the postoperative pathomorphological investigation conduction was substantiated because of high degree of the cystic pancreatic tumors polymorphism presence and low informativity of preoperative and intraoperative investigations.

Adenoma↗
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↗
PubMed2004

[Application of endoscopic investigation in diagnosis of duodenal major papilla cancer].

Endoscopic ultrasonographic investigation (EUSI) was performed in 12 patients with duodenal major papilla cancer, to whom the performance of radical surgical intervention was planned. In 9 patients the diagnosis, according to the EUSI data, was confirmed, in 1--cancer of pancreatic head was diagnosed, in 1--adenoma of duodenal major papilla, in 1--false-negative result was obtained Results of investigation was confirmed intraoperatively and according to the histological investigation data. Application of EUSI have permitted to determine correctly before the operation the stage of the disease in 8 of 9 patients. The method may be applied for verification of the diagnosis in patients with cancer of duodenal major papilla

Aged↗
PubMed2003

[Surgical treatment of pancreatic fistula].

Results of treatment of 149 patients with external pancreatic fistula for 1990-2000 yrs period were analyzed. Roentgencontrast fistulography, ultrasonic investigation, endoscopic retrograde pancreatography are the main diagnostic methods of the disease. Conservative therapy was conducted in 57 patients, sandostatin was administered in 0.1 ml dosage subcutaneously every 8 h during 5-8 days. It turned to be effective in 42 (73.7%) of patients. Fistulopancreatojejunostomy, fistulojejunostomy, pancreatic resection of its part, carrying fistula, were the main methods of operative treatment. Postoperative complications occurred in 7 (7.6%) of patients. All the patients are alive.

Adolescent↗
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

[Strategies of surgical treatment of chronic pancreatitis complicated by obstructive jaundice and cholangitis].

The results of treatment of 295 patients with complicated chronic pancreatitis (CP) for period from 1996 to 2000 yr were presented. CP without the ducts dilatation was revealed in 37 patients, ductal hypertension--in 19, calcinose fibrous-degenerative CP--in 73, cystic form of CP--in 142, CP in combination with external pancreatic fistula--in 24. Frequency of the complications occurrence in various forms of CP--the obstructive jaundice and cholangitis--was analyzed. Complex approach to the choice of tactic of the operation performance was proposed, application of additional methods of sorptional and immune therapy, depending on the CP form, complicated by the obstructive jaundice and cholangitis, was substantiated.

Adult↗
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↗
PubMed2002

[Classification of tumors of extrahepatic biliary ducts].

Basing on morphologic-anatomical peculiarities of extrahepatic biliary ducts (EBD) analysis the classification of their tumors was elaborated. The EBD portions borders were determined: the proximal, with predominant affection of right and left biliary duct, their branching; the central; the therminal; affection of common biliary duct ampulla and large duodenal papilla. Basing on the classification proposed, surgical tactics of the EBD tumors treatment was elaborated.

Adult↗
PubMed2002

[Modern aspects in the diagnosis of pancreatic lobe and extrahepatic biliary duct neoplasms].

There were examined 385 patients with pancreatic head and extrahepatic biliary ducts tumor. Complex of diagnostic measures was proposed using modern methods: ultrasonic investigation, endoscopic retrograde cholangiopancreatography, computeric tomography, magnet resonance tomography, spiral computeric tomography. Diagnostic possibilities of each method in the tumor verification and in revealing of indirect science of disease were studied up. Correct diagnosis was established in 94.3% of observations.

Adult↗