Publications (15)0 Total impact
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Khirurgiia 01/2013;
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V A Kubyshkin,
A G Kriger,
I A Kozlov,
V N Tsygankov,
Iu G Starkov,
D S Gorin,
A V Kochatkov, S V Berelavichus,
I Iu Nedoluzhko,
A B Varava,
S S P'ianikin
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ABSTRACT: 585 patients were operated on the reason of chronic pancreatitis. 246 patients received various drainig operations: cystojejunostomy with Roux-en-Y anastomosis (n=97), longitudinal pancreatojejunostomy (n=86), external draining of the absceding postnecrotic cysts (n=51), internal draining (n=12). Resections of the pancreas were performed in 327 cases: Frey operation (n=83), Beger operation (n=46), pancreatoduodenal resection (n=61) - of them 55 were suspicious to cancer and 6 had pancreatic dystrophy. Distal resection of the pancreas was performed in 6 cases. 33 patients were operated on pseudoaneurisms, of the 12 patients received endovascular operations. Posoperative complications were registerd in 119 (20.3%) patients. 7 (1.2%) patients died.
Khirurgiia 01/2013;
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ABSTRACT: 23 pancreatectomies were made on the reason of various tumors of the pancreas during the period of 2009-2012yy. 15 patients had duct adenocarcinoma, 4 - neuroendocrine neoplasia, 2 - intraductal papillary-mucinous tumor, 1 had metastase of renal-cell carcinoma and 1 was diagnosed with serous cystadenoma. Pancreatectomy was indicated in case of invasion of the whole pancreas or in case of multiple tumor focuses. By adenocarcinoma the pancreatecomy was abstained in case of large vessels (a. mesenterica suoerior, truncus coeliacus and hepatic arteries) invasion or remote metastases presense or impossibility of R0 resection. Metastases and vessel invasion were not considered as contraindication to pancreatectomy in patients with neuroendocrine lesions. 10 (43.5%) patients had postoperative complications; 2 patients died. The survival median was 7 months for the duct adenocarcinoma. Postoperative life duration for patients with othe pancreatic tumors was 6-36 months.
Khirurgiia 01/2013;
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ABSTRACT: The results of 302 operations on the pancreas were analyzed: of them 107 were pancreatoduodenal resections; 67 were distal resections of the pancreas; 74 were various resections of the head of the pancreas and middle resections and 54 other operations. The postoperative pancreatitis was registered in 178 patients. The preventive use of the octreotide intraoperatively and in early postoperative period showed no influence on the frequency and severity of the postoperative pancreatitis. The ultrasound was the optimal screening diagnostig method, whereas the computed tomography was the best in pancreonecrosis diagnostics and the volume of the pancreatic tissue damaged. Of 178 patients with the postoperative pancreatitis 17 died, the lethality rate was 9.5%.
Khirurgiia 01/2012;
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ABSTRACT: 4 clinical cases of metastatic invasion of pancreas by renal cancer were analyzed. The main features were the late metastatic revealance and the absence of specific clinical picture. The radiodiagnostics showed signs similar to neuroendocrine tumors of the pancreas, which complicated the diagnosis. All the patients were operated on - the resection of the pancreas was performed.
Khirurgiia 01/2012;
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ABSTRACT: 15 patients with solid-pseudopapillary tumors of the pancreas (SPTP) were investigated. There were no specific clinical signs of the disease revealed; the major common clinical sign was the upper abdominal pain. Of the diagnostic methods the ultrasound together with endoscopic ultrasound, computed tomography and magnetic resonance imaging were used. Specific diagnostic feature of SPTP is the heterogenous structure and even contours and capsule. Any changes of pancreatic duct are untypical. All 15 patients were operated on. The intraoperative urgent histological analyze together with postoperative immunohystochemical investigation were performed in all cases. 11 patients developed the postoperative pancreatitis. The long-term follow up results were obtained in 15 patients. The disease progression was registered in one case.
Khirurgiia 01/2012;
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ABSTRACT: The indications to Frey operation are severe pain syndrome and pancreatic hypertension, caused by concrements and strictures of the main pancreatic duct and/or postnecrotic pancreatic cysts. The pancreaticojejunoanastomosis is performed on the isolated by Roux intestinal loop. The average operating time was 4.62±1.39 hours. 28,3% of the operated patients developed various postoperative complications. 2 (6.7%) patients had the anastomosis insufficiency; the 2 patients had intraanastomotic bleeding and 1 patient had the arrosive bleeding caused by pancreonecrosis. 2 patients had external pancreatic fistulae. 1 patient died. The average hospital stay after the operation was 12±4 days.
Khirurgiia 01/2012;
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Khirurgiia 01/2011;
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A G Kriger,
A A Zviagin,
S V Korolev,
A O Zhukov,
A V Kochatkov,
E I Bozh'eva,
R Z Ikramov, S V Berelavichus,
I A Kozlov,
A V Kolygin,
E A Akhtanin
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ABSTRACT: Treatment results of 5 patients with unformed intestinal fistulae are represented. High unformed intestinal fistulae are acknowledged to be completely unsuitable for conservative treatment and should be operated on. Complex treatment should include complete parenteral feeding, adequate fecal diversion with the use of aspirational drainage. Surgical treatment must be y the increase of fistula discharge or absence of fistula formation. Low intestinal fistulae should better be surgically dissected after their organization, otherwise urgent surgery is to be performed by complications development, such as purulent leakage into the abdominal cavity or severe wound infection.
Khirurgiia 01/2011;
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ABSTRACT: 15 patients with intraductal papillary-mucinous tumors (IPMT) of the pancreas were observed. Clinical manifestation corresponded with chronic pancreatitis. Ultrasound study, including endosonography, contrast-enhanced computer and magnetic resonance tomography were used in complex observation of the patients. Dilation of main or lateral pancreatic ducts, connection of tumor with pancreatic duct system and absence of septal calcinosis are typical signs in radiodiagnostics of IPMT. Visualization of parietal papillary proliferations and their contrast enhancement are undeniable signs f or neoplastic character of pancreatic duct dilation. Sensitivity of CT, MRТ and endoUS amounted accordingly 66, 83 and 88%. All patients were operated. Extent of operation was determined by morphological character, localization and size of the tumor (pylorus-preserving pancreaticoduodenal resection was carried out to 6 patients, distal resection including robot-assisted - to 7 patients, midline resection - to 1 patient, duodenum-preserving resection of head and body of pancreas - to 1 patient). Intraoperative urgent histologic study of pancreatic section was carried out by all means. Tumors with borderline degree of malignancy were detected in 4 cases.
Khirurgiia 01/2011;
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ABSTRACT: The experience of single institution of 43 robotic-assisted operations in the abdomen and retroperitoneal space has been analyzed. The problem of port placement conditioned the preoperative computed 3D-modelling of the operative course. The procedure allowed to optimize the movements of the robotic manipulators, decrease the risk of organ injury and overall incidence of intra- an postoperative complications.
Khirurgiia 01/2011;
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ABSTRACT: Since March 2009 10 operations were performed using the DaVinci robotic complex. Five liver resections were performed for nonparasitic hepatic cyst or fibronodular hyperplasia, one case of splenectomy - for nonparasitic spleen cyst abscess, distal pancreatic resection - for cystocarcinoma of the pancreas, adrenalectomy, gastric fundal resection - for gastrointestinal stromal tumor and one case of left hemicolectomy - for adenocarcinoma of the descending colon. The first robotic-assisted operations proved the need for exact preoperative localization of the operative area. It provides adequate disposition of the instruments and devices of the operative complex. The use of the robotic complex provides a precisional surgical technique, excludes physiological hand tremor and allows a minor traumaticity of the operation. The successful use of the DaVinci complex requires, though, certain skills of handling the instruments, using the robotic console.
Khirurgiia 01/2010;
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Khirurgiia 02/2005;
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Khirurgiia 02/2003;
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ABSTRACT: Experience of treatment of 162 patients with acute adhesive intestinal obstruction (AAIO) is described. These patients had most often (23.3%) appendectomy in anamnesis. Conservative treatment was effective in 23 (14.2%) patients only. Surgical treatment was performed in 139 (85.8%) patients including traditional open operation in 79 (56.8%) patients, laparoscopic and laparoscopy-assisted in 60 (43.2%). Advanced adhesive process with formation of single intestinal conglomerate, neglected forms of AAIO with paralytic ileus were indications to open operations; lethality in these operations was 17.7%. Laparoscopic operation was indicated in AAIO due to isolated commissure as well as in early adhesive obstruction; lethality was 1.7%. If diagnostic laparoscopy showed that AAIO is caused by intestinal deformation in small intestinal conglomerate or intestinal resection is required, laparoscopy-assisted operations were performed.
Khirurgiia 02/2001;
