RESUMEN
Experience of 84 patients treatment for complicated pancreatic gland pseudocysts is presented. Tactics of diagnosis and treatment for complicated pancreatic gland pseudocysts was elaborated and substantiated. Individualized treatment-diagnosis approach provides, first of all, the complications elimination, an adequate surgical treatment of pancreatic gland pseudocyst is possible in late period. For complicated pancreatic pseudocysts treatment miniinvasive methods were used predominantly, when their application is impossible or fails the open procedure is performed.
Asunto(s)
Drenaje/métodos , Páncreas/cirugía , Seudoquiste Pancreático , Adulto , Anciano , Angiografía , Diagnóstico Diferencial , Endoscopía del Sistema Digestivo , Procedimientos Endovasculares , Femenino , Hemorragia/diagnóstico por imagen , Hemorragia/etiología , Hemorragia/cirugía , Humanos , Masculino , Persona de Mediana Edad , Páncreas/irrigación sanguínea , Páncreas/diagnóstico por imagen , Fístula Pancreática/diagnóstico por imagen , Fístula Pancreática/etiología , Fístula Pancreática/cirugía , Seudoquiste Pancreático/complicaciones , Seudoquiste Pancreático/diagnóstico por imagen , Seudoquiste Pancreático/cirugía , Enfermedades Pleurales/diagnóstico por imagen , Enfermedades Pleurales/etiología , Enfermedades Pleurales/cirugía , Supuración , Resultado del Tratamiento , Ultrasonografía , Adulto JovenRESUMEN
The data of complex clinical examination and surgical treatment of 89 patients, having splenic cysts (SC), are analyzed. Indications and contraindications for miniinvasive methods of treatment (laparoscopic and puncture-draining procedures under ultrasonographic control) application are substantiated, taking into account their size, localization, pathogenesis and presence of SC complications. Diagnostic efficacy of abdominal ultrasonography, computer tomography for SC was estimated, the significance of these methods, while choosing a rational tactics of treatment, was determined. There were elaborated and introduced into clinical practice the stages of endosurgical procedures, including performance of organpreserving operations for SC. Introduction of the elaborated diagnostic algorithm and tactics of treatment of SC have permitted to reduce postoperative complications rate and the patients stay in hospital, improving their quality of life as well.
Asunto(s)
Quistes/cirugía , Drenaje/métodos , Laparoscopía/métodos , Esplenectomía/métodos , Enfermedades del Bazo/cirugía , Adolescente , Adulto , Anciano , Quistes/diagnóstico por imagen , Quistes/patología , Diagnóstico Diferencial , Femenino , Humanos , Masculino , Persona de Mediana Edad , Complicaciones Posoperatorias/epidemiología , Complicaciones Posoperatorias/etiología , Complicaciones Posoperatorias/prevención & control , Estudios Prospectivos , Estudios Retrospectivos , Enfermedades del Bazo/diagnóstico por imagen , Enfermedades del Bazo/patología , Resultado del Tratamiento , Ultrasonografía , Adulto JovenRESUMEN
The options, indications and contraindications for conduction of transcutaneous diagnostic interventions under ultrasonographic control in diffuse and focal hepatic affection were studied up. The procedure technique of the fine-needle aspiration and the tissue hepatic biopsy was adduced. Comparative analysis of the biopsy needles owing various constructions and diameters was conducted. High efficacy of transcutaneous biopsy under ultrasonographic control for the hepatic diseases diagnosis was proved.
Asunto(s)
Biopsia con Aguja Fina/métodos , Hígado/diagnóstico por imagen , Hígado/patología , Humanos , Consentimiento Informado , UltrasonografíaAsunto(s)
Absceso Hepático , Humanos , Absceso Hepático/diagnóstico , Absceso Hepático/etiología , Absceso Hepático/patología , Absceso Hepático Amebiano/diagnóstico , Absceso Hepático Amebiano/etiología , Absceso Hepático Amebiano/patología , Absceso Piógeno Hepático/diagnóstico , Absceso Piógeno Hepático/etiología , Absceso Piógeno Hepático/patologíaRESUMEN
Estimation of possibilities of dynamic ultrasonic investigation and transcutaneous echocontrolled interventions in diagnosis of various forms of an acute pancreatitis and its complications while examination of 283 patients was conducted. High efficacy of echography and of transcutaneous interventions in early diagnosis of the disease was proved.
Asunto(s)
Quiste Pancreático/diagnóstico por imagen , Pancreatitis/diagnóstico por imagen , Enfermedad Aguda , Adulto , Anciano , Diagnóstico Diferencial , Femenino , Humanos , Masculino , Persona de Mediana Edad , Quiste Pancreático/complicaciones , Pancreatitis/complicaciones , UltrasonografíaRESUMEN
Results of treatment of some surgical diseases of the hepatopancreatoduodenal zone organs using transcutaneous intervention under the ultrasonic investigation control were analyzed. There were confirmed their high efficacy in the treatment of focal purulent diseases, hepatic cyst, possibility of application as primary surgical manipulation in treatment of destructive forms of an acute pancreatitis and in external drainage of biliary ducts for obstructive jaundice. Perspective trends of the method usage were determined.
Asunto(s)
Celulitis (Flemón)/diagnóstico por imagen , Celulitis (Flemón)/cirugía , Colestasis/diagnóstico por imagen , Colestasis/cirugía , Quistes/diagnóstico por imagen , Quistes/cirugía , Hepatopatías/diagnóstico por imagen , Hepatopatías/cirugía , Humanos , Piel , UltrasonografíaRESUMEN
In 46 patients with an destructive acute pancreatitis (AP) the invasive intervention under control of ultrasonography, in 38 of them--in stage of purulent complications, was performed. It had promoted stabilization of state in 39 (89.8%) patients, normalization of clinic--laboratory indexes, that had permitted to realize radical operative intervention with minimum risk in perspective. Invasive intervention under control of ultrasonography--highly effective primary surgical manipulation in complex of treatment of the destructive AP severe forms.
Asunto(s)
Pancreatitis Aguda Necrotizante/diagnóstico por imagen , Pancreatitis Aguda Necrotizante/cirugía , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pancreatitis Aguda Necrotizante/diagnóstico , Índice de Severidad de la Enfermedad , Piel , Succión/métodos , UltrasonografíaRESUMEN
The ultrasonic semiotics of different diseases of hepar, pancreas, gallbladder, colon, postoperative complications was elaborated and complicated. New and complicated technological procedures for the complex ultrasonic investigation in before, intra- and postoperative periods were proposed. Minor traumatic transcutaneous intervention procedures under the ultrasonic control for the abdominal cavity and retroperitoneal space abscess, cysts of various localization were used for the first time in domestic practice. The treatment procedures applied ranged from puncture with subtle aspirating needle to one- or two-staged drainage performance. Clinical effectiveness constituted 85.2%.
Asunto(s)
Ultrasonografía Doppler/tendencias , Diagnóstico Diferencial , Humanos , Cuidados Intraoperatorios , Hígado/diagnóstico por imagen , Hígado/cirugía , Absceso Hepático/diagnóstico por imagen , Absceso Hepático/cirugía , Enfermedades Pancreáticas/diagnóstico por imagen , Enfermedades Pancreáticas/cirugía , SucciónRESUMEN
The authors have observed 218 patients with nonparasitogenic cyst of the liver. Of them 94 were operated on. The cyst enucleation, partial excision of its wall, external cyst drainage, cystodigestive anastomosis formation, combined liver and the cyst resection were done. Preference to the cyst enucleation (in 22.5% of observations), its partial excision (in 33.8%) and combined resection of liver with the cyst (in 19.4%) was given. In polycystosis the partial excision of large cysts were the alternative operations as well as omento-hepatopexy. One (1.06%) patient have died. Postoperative complication occurred in 23 (24.2%) of patients.