The article presents a minimally invasive method for treating strictures of a biliodigestive anastomosis, which consists in creating access to the intestinal lumen without entering the abdominal cavity. A guideline in this is the scar on the anterior abdominal wall, which remained after the removal of the circular drainage or Volker's drainage. In this way, in our clinic, 10 patients were operated on after an operation to form a biliodigestive anastomosis on a disconnected RF loop. A clinical case with a follow-up period of more than 10 years is presented. There was no recurrence of strictures, and according to the data of clinical, echographic and biochemical examinations, all of them had a good long-term result.
The article presents a review and analysis of modern conceptions about the course of acute destructive pancreatitis, according to national and international recommendations. The problematic and perspective questions of treatment of this pathology are highlighted. The key directions of treatment of acute destructive pancreatitis are determined, according to the authors, requiring additional development.
Relevance. Liver abscesses remain one of the most urgent problems in abdominal surgery, reaching 2-3 cases per 100,000 people. A wide range of causes, the complexity of diagnosis and the imperfection of treatment methods reaching a high mortality, from 2 to 31% according to different authors. The abscesses developing as a complication in the postoperative period are the greatest difficulty in diagnosis and treatment. The advantage of minimally invasive technologies at the present stage of development of surgery is indisputable. However, the question remains of the indications for their use, phasing and technology of implementation. Purpose of the study. On the clinical example, to show the possibility, logic and sequence of minimally invasive treatment in a patient with multiple liver abscesses. Materials and methods. Presented a clinical case of minimally invasive treatment of postoperative complications in a patient receiving primary treatment for multiple primary cancer - cholangiocarcinoma and kidney cancer with the development of multiple liver abscesses of the ambiguous nature (cholangiogenic, pyogenic, traumatic, ischemic). Result. In the presented clinical case are presented the possibilities of a staged, minimally invasive treatment of multiple liver abscesses
The article presents a method of treatment of patients with multiple duodenal injuries, which consists in implanting a section of the duodenum with a Vater papilla into the small intestine, which avoids complex and traumatic operations on the biliary tract and related complications. We present a clinical case with a follow-up period of 7 years. No data were obtained for the presence of complications in the long-term period.
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