[Treatment of acute cholecystitis in a specialized department].
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Biomedical subjects
Publications and source records attributed to V S Zemskov.
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The authors observed 136 patients with pancreatic cysts. Complicated forms of the disease were found in 26 patients. It was established that despite apparent signs of disturbed functioning of the pancreas for a long time there was not a single case of correct diagnosis in local hospitals. The greatest amount of errors were made in surgical interventions in patients with pancreatic cysts.
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The methods of drainage of the pancreas bed and the abdominal cavity in 184 patients were analyzed. New principles of drainage of the pancreas bed in destructive forms of acute pancreatitis were elaborated for its irrigation beginning from early postoperative period preventing the spread of the neccrotic suppurative process. The indications and technique of drainage of the abdominal cavity, biliary ducts and gastrointestinal tract in acute pancreatitis were developed.
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The authors observed 103 cases of pancreatic cysts caused by acute pancreatitis, aggravation of chronic pancreatitis (81.0%) and trauma to the pancreas (12.0%). The posttraumatic cysts were more common in children and young adults (86.0%). The use of the complex method of diagnosis (x-ray examination of the gastrointestinal tract, celiacography, and upper mesentericography, endoscopic pancreatography, ultrasound echolocation of the pancreas) allowed to establish the diagnosis in 91.6% of cases. The external drainage of the cysts was carried out in cases of infected cysts with poorly formed walls. In case of a dilated and deformed main pancreatic duct with disorder of its patency (21 cases) the longitudinal cystopancreatojejunostomy was performed. The lethality after internal drainage constituted 2.4%. 80.8% of patients showed good long-term results of the treatment and 14.4%--showed fair results. 2 patients (2.1%) developed the recurrence of the cyst.
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The authors operated 15 cases with polycystotic liver. The diagnostic value of ultrasound echolocation and hepatoscanning in polycystosis was noted. In authors' opinion the surgical treatment of polycystotic liver should be carried out in due time during the clinical manifestations phase and ought to be radical enough to yield satisfactory results.
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