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Biomedical subjects

V P Glabaĭ

Publications and source records attributed to V P Glabaĭ.

18 recordsLinked to original sources

[Recurrent pancreatitis as a surgical problem].

Experience in the treatment of 1498 patients with alcoholic pancreatitis treated with laparotomic and mini-invasive surgeries both in acute and chronic phases of the disease is presented. In 742 patients surgical treatment was multistaged. Re-operations in 17 patients with "chronic purulent pancreatitis", reconstructive surgeries on the pancreas, pancreatic and bile ducts in 84 patients with "head" pancreatitis were most difficult. Percutaneous puncture-catheter procedures for liquid formations in acute phase of pancreatitis were effective as the first stage of treatment to reduce the danger of subsequent laparotomy. Catheterisation of chronic pseudocysts in alcoholic pancreatitis is associated with frequent complications and recurrences and can not be regarded as alternative to internal drainage surgeries. Pancreatic surgeries must guarantee effective correction of intrapancreatic hypertension for prevention of acute pancreatitis recurrences. In acute phase of pancreatitis surgical methods must ensure prevention of symptoms recurrences and pyoseptic complications of pancreatitis.

Chronic Disease↗

[Problems in the surgical treatment of pancreatic chronic diseases].

The work analyses the results of 999 operations on the pancreas conducted in 861 patients with chronic oncological and nonneoplastic diseases of the gland. Pancreatoduodenal resection (PDR) was performed in 171 patients (for tumors of the pancreaticoduodenal zone in 151 and for chronic pancreatitis of the head of the gland in 20) in 13 of them a modified operation with preservation of the stomach and pylorus was carried out. The late-term results were satisfactory in both groups of patients, the survival of oncological patients was much higher after radical operations then after palliative surgery. Total duodenopancreatectomy has no advantages over PDR and should be undertaken only when there are strict indications. In chronic pancreatitis, complicated also, preference was given to organ-preserving interventions, primarily to draining operations, which preserve more fully pancreatic exocrine and endocrine functions: longitudinal pancreatojejunostomy was conducted in 106 patients, internal drainage of pancreatic cysts in 184, and occlusion of external pancreatic cysts in 70 patients. It is advisable that the most complicated, particularly repeated and reconstructive, operations on the pancreas are carried out at specialized centers in which the problem of surgical diseases of the pancreas is studied more closely.

Chronic Disease↗

[Choice of bile-diverting operations in neoplastic obstruction of the distal common bile duct].

Analysis of clinical material of 206 patients with tumor obstruction of the distal part of the common bile duct allowed the conclusion to be made on the expediency of applying endoscopic methods for jaundice correction as the first stage in preparation for the operation (122 patients) and also as the only and final operation (70 patients). Study of the immediate and late-term results of different variants of operations for bile diversion in obstruction of the distal choledochus (203 operations) showed the superiority of the Roux hepaticoejunoanastomosis in which recurrent jaundice due to obstruction of the cystic duct does not occur, as is encountered in creation of a cholecystoejunoanastomosis, and there are no conditions for the development of ascending cholangitis.

Adult↗

[Subtotal pancreatic resection in chronic pancreatitis].

Eight patients with chronic pancreatitis were subjected to subtotal (95%) resection of the pancreas. The authors believe that such surgical intervention should be performed when the pathological process had involved the left half of the gland, while its head remained little changed or intact. Subtotal resection is indicated also in cases of primary pancreatitis when the organ parenchyma is changed and the major pancreatic duct is not dilated. In such cases it is not expedient to make a pancreato-digestive anastomosis.

Chronic Disease↗