Gepatologiia i gastroenterologiia最新文献

{"title":"EFFECTIVENESS OF PORTAL BLOOD FLOW OCCLUSION TECHNIQUES WHEN PLANNING EXTENSIVE RESECTIONS IN PATIENTS WITH LIVER ECHINOCOCCOSIS","authors":"A. Krasnov, V. Anischenko, K. Krasnov, V. Pelts, O. A. Krasnov, V. Pavlenko","doi":"10.25298/2616-5546-2023-7-1-74-80","DOIUrl":"https://doi.org/10.25298/2616-5546-2023-7-1-74-80","url":null,"abstract":"Background. Surgery is the main and an effective treatment option for liver echinococcosis. The choice of surgical strategy for advanced liver echinococcosis given suspected poor liver functional reserve and post-operative hepatic failure remains challenging. Objective. To present and analyze the effectiveness of portal blood flow occlusion techniques in planning two-stage extensive resections in patients with advanced liver echinococcosis. Material and methods. The article presents the outcomes of surgical treatment of 22 patients (8/36,4% men, 14/63,6% women) operated on for advanced liver echinococcosis in the surgical department No.2 of State Autonomous Healthcare Institution ‘Kuzbass Clinical Emergency Hospital named after A.I. M. A. Podgorbunsky’ (Kemerovo). The application of a two-stage extensive resection protocol was used as an entry criterion. Stage I included right portal vein branch occlusion techniques aimed at achieving vicarious hypertrophy of the contralateral lobe. A two-stage extensive resection protocol was applied in case of both expected poor hepatic functional reserve and insufficient future remnant liver volume, accounting for inability of safe implementation of a one-stage extensive resection due to predicted postoperative hepatic failure and a fatal outcome. Results. The applied two-stage resection techniques for the prevention of post-operative hepatic failure are effective in relation to the following indicators: CT volumetry (p<0,05), OK15 ICG (p<0,05), statistical model value (p<0.05). Though the laparotomic technique of the right portal vein branch ligation is of a comparable effectiveness with the laparoscopic one, the latter being less traumatic, which can significantly reduce postoperative hospital stay (p<0,05). Moreover, the laparoscopic technique was not found to cause any specific and nonspecific complications. Conclusions. The applied methods of portal blood flow occlusion are considered to be effective and safe when planning two-stage extensive resections in specialized hepatology centers and can be recommended in case of initial poor hepatic functional reserve and insufficient future remnant liver volume.","PeriodicalId":34878,"journal":{"name":"Gepatologiia i gastroenterologiia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45160647","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CLASSIFICATIONS AND NON-SURGICAL TREATMENT OF ACUTE APPENDICITIS IN ADULTS: A COMPARATIVE LITERATURE REVIEW","authors":"А. М. Побылец, С. И. Кояло, А. M. Pobylec, S. I. Koyalo, Pobylec Andrei","doi":"10.25298/2616-5546-2023-7-1-21-27","DOIUrl":"https://doi.org/10.25298/2616-5546-2023-7-1-21-27","url":null,"abstract":"The issue of non-surgical treatment of acute appendicitis (AA) remains debatable in modern literature. In the last decade, a number of large studies have been conducted on this approach to the treatment of acute inflammation in the appendix. The researchers do not often come to the same conclusions or even have contrary opinions. This review highlights the differences in AA classifications. The analytical part includes a comparison of six original research articles on non-surgical treatment of AA. The objective was to identify potential reasons for inconsistent results of the studies and to outline the possibilities of non-surgical treatment of AA and its disadvantages.","PeriodicalId":34878,"journal":{"name":"Gepatologiia i gastroenterologiia","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42058557","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ANATOMICAL AND EXPERIMENTAL REASONING OF LIVER RESECTION USING HYDRODISSECTION TECHNIQUE","authors":"I. Zuk, P. M. Lozhko, V. V. Kudlo, T. S. Gushcha, Yu. M. Kiselevskiy","doi":"10.25298/2616-5546-2023-7-1-37-42","DOIUrl":"https://doi.org/10.25298/2616-5546-2023-7-1-37-42","url":null,"abstract":"Background. Due to an increasing number of liver surgery, the problems of using secure hemostatic techniques during its resection are still relevant and require further study. Objective. To determine the optimal technique of local hemostasis during liver resection based on a comparative morphological assessment of the liver wound. Material and methods. The study was performed on 30 outbred white rats using local hemostatic techniques with further morphological examination of biological material on 7th and 21st days. Results. It has been established that cryohemostasis, electrocoagulation and local application methods of hemostasis are adequate ways to stop blood loss from a wound during liver resection. The analysis of the histological image of micro-preparations showed that the inflammatory response is present in all experiment series, regardless of hemostatic techniques. The disadvantage of using a TachoComb sponge is the need for its fixation to the wound surface, that of a collagen hemostatic sponge – a long period of its resorption, that of electrocoagulation – a damaging effect on liver tissue with marked inflammation. Conclusions. Local cryohemostasis appeared to be the most effective bleeding control technique. Its advantages are the following: it stops bleeding much faster than application techniques; it is characterized by minimal abdominal adhesions; it has a less pronounced damaging effect on liver parenchyma; it facilitates scar tissue formation and it is less likely to cause inflammatory changes in the resection zone.","PeriodicalId":34878,"journal":{"name":"Gepatologiia i gastroenterologiia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43879092","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Materials of the Republican scientific and practical conference with international participation “Topical Issues of Socially Significant Infectious Diseases” dedicated to the 60th anniversary of the Department of Infectious Diseases, October 28, 2022","authors":"","doi":"10.25298/2616-5546-2022-6-2-141-171","DOIUrl":"https://doi.org/10.25298/2616-5546-2022-6-2-141-171","url":null,"abstract":"","PeriodicalId":34878,"journal":{"name":"Gepatologiia i gastroenterologiia","volume":"12 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41303722","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CLINICAL-EPIDEMIOLOGICAL AND MOLECULAR-GENETIC CHARACTERISTICS OF THE FIRST CASE OF ACUTE HEPATITIS E IN THE GRODNO REGION","authors":"V. Tsyrkunov, V. Davydov, S. Zhavoronok, L. K. Chernyak, A. Babenka, S. Marchuk, E. Gasich, I. Zadora","doi":"10.25298/2616-5546-2022-6-2-115-122","DOIUrl":"https://doi.org/10.25298/2616-5546-2022-6-2-115-122","url":null,"abstract":"Background. The emergence of hepatitis E virus (HEV) in developed countries is driven by improved diagnostic tools, increased clinician awareness of the autochthonous nature of transmission and the potential for life-threatening acute and chronic liver damage. Objective. To present the first confirmed case of acute hepatitis E (AHE) caused by the E virus of the first genotype (HEV-1) in the Grodno region, registered in 2022. Material and methods. The patient is a native of Pakistan, who has been living and working in Grodno for recent years. He visited Italy and Pakistan several times within last six months, returned to Grodno 2 weeks before the onset of clinical manifestations of the disease. The patient was hospitalized in the Regional infectious diseases hospital. The methods for laboratory and etiological diagnosis of hepatitis included: general clinical methods, serological and molecular genetic ones (ELISA - IgM, IgG HEV; PCR - RNA HEV, genotyping and sequencing of the HEV genome). Results. Epidemiological, clinical and laboratory methods made it possible to exclude viral hepatitis A, B, C, D and establish the diagnosis of AHE of icteric (bilirubin at the height of the disease - 209.1 μmol/l, ALT - 1795 U/l), moderate form with a favorable outcome. IgM and IgG to HEV were detected in the patient's blood. HEV RNA was isolated from the patient's biological material. The isolated sequence in 100% bootstrap replications was assigned to HEV genotype 1. The insignificant value of the evolutionary distance between the \"Grodno\" sequence and the sequence isolated from a patient's body in Pakistan indicated a high degree of their homology, which made it possible to conclude that this case of AHE was imported. Conclusions. For the first time in the Grodno region, there was registered an imported case of AHE acquired during travel to HEV hyperendemic territory. The identified sequence is 100% HEV-1 genotype and 94.3% homologous to the sequence obtained from a patient in Pakistan. Under favourable conditions, HEV-1, which has a significant epidemic potential, can cause the development of HEV outbreaks.","PeriodicalId":34878,"journal":{"name":"Gepatologiia i gastroenterologiia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44308163","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A RARE CASE OF OMPHALOCELE WITH TUBULAR ILEAL DUPLICATION AND VITELLINE FISTULA (CASE REPORT)","authors":"V. V. Navasad, V. I. Kavalchuk, K. A. Navasad","doi":"10.25298/2616-5546-2022-6-2-134-137","DOIUrl":"https://doi.org/10.25298/2616-5546-2022-6-2-134-137","url":null,"abstract":"Background. A hernia of the umbilical cord (omphalocele) is a congenital abnormality in which a number of the abdominal organs are located extraperitoneally - in the umbilical membranes, consisting of the amnion, Wharton's jelly and the primary undifferentiated peritoneum. Digestive tract doublings constitute a group of rare malformations that vary significantly in appearance, location, size, and clinical manifestations. The incidence of this pathology is one case per 4500 autopsies. The first case of an intestinal duplication was reported by Calder in 1733. Objective. To demonstrate diagnosis and treatment of a rare case of omphalocele with tubular ileal duplication and vitelline fistula in a newborn. Material and methods. A clinical case report of 2-day-old patient L. who underwent treatment in the neonatal department of the Grodno Regional Children's Clinical Hospital in December 2021. Results. The child was found to have omphalocele with tubular ileal duplication and vitelline fistula. After preoperative preparation, the patient underwent an operation: abdominal reconstructive intervention to correct a congenital malformation. The treatment resulted in a complete recovery. Conclusions. We presented a case report not yet published in literature. Despite the complexity of the anomaly, the patient was discharged having fully recovered. The follow-up examination in 2022, detected no deviations in the child’s development.","PeriodicalId":34878,"journal":{"name":"Gepatologiia i gastroenterologiia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46294501","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ASSOCIATION OF ESOPHAGEAL AND GASTRIC VARICES WITH OTHER PHENOTYPIC STIGMAS OF EPATIC CIRRHOSIS","authors":"E. I. Mikhailova, A. Sennikova, E. L. Krasavtsev, N. Trofimova, О. S. Pershenkova","doi":"10.25298/2616-5546-2022-6-2-123-127","DOIUrl":"https://doi.org/10.25298/2616-5546-2022-6-2-123-127","url":null,"abstract":"Background. Portal hypertension resulted from the increased pressure in the portal system is one of the leading syndromes of liver cirrhosis. A frequent and often fatal manifestation of portal hypertension is upper gastrointestinal bleeding mainly due to varicose veins of the esophagus and the stomach. Objective. To study the prevalence of esophageal and gastric varices and their association with other phenotypic stigmas of cirrhosis. Material and methods. A total of 108 patients with cirrhosis, including 46 (42.59%) men and 62 (57.41%) women, were included in the study. Results. Varicose veins were detected in 77 (71,3%) of 108 examined patients. All varices were localized in the esophagus. Of all patients examined, 36 patients (33.33%) were Child-Pugh class A, 58 patients (53.70%) were class B, and 14 patients (12.96%) were class C. Among Class A patients, 9 patients (11.7%) had grade I varicose veins, 9 patients (11.7%) had grade II, 8 patients (10.4%) had grade III, while 13 patients (16.9%), 24 patients (31.2%) and 3 patients (3.9%) had grade B varicose veins, respectively. All patients classified as class C had large varicose veins. The size of varices was associated with the severity of liver cirrhosis (τ=0.2, 95% CI: p˂0.05). Grade II-III varices were seen in 55 patients (50.9%), 9 of whom (16.4%) had a history of gastrointestinal bleeding. Such complication was not observed in any patient with class A cirrhosis, but occurred in all patients with Child-Pugh class C cirrhosis. Conclusions. Patients with liver cirrhosis should undergo follow-up upper GI endoscopy for early detection of varices and, if necessary, for prescription of prophylactic therapy to reduce the risk of bleeding and associated high mortality.","PeriodicalId":34878,"journal":{"name":"Gepatologiia i gastroenterologiia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43324588","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"MORPHOLOGICAL ASPECTS OF FLUORINATED POLYMERS BIOINTEGRATION IN THE EXPERIMENT","authors":"V. V. Kudlo, I. G. Zhuk, I. S. Tsydik, N. Prokopchik","doi":"10.25298/2616-5546-2022-6-2-99-104","DOIUrl":"https://doi.org/10.25298/2616-5546-2022-6-2-99-104","url":null,"abstract":"Background. There exist strict requirements for polymer materials to be used for implantation into living organisms, thus, no substance lacking negative properties has been found yet. Various groups of polymers are currently under research, including fluorinated polytetrafluoroethylene families. Objective. To evaluate the peculiarities of morphological reactions that occur during implantation of Belarusian fluoroplast-4 into various tissues of experimental animals. Material and methods. The experiments were carried out on outbred white rats weighing 200-250 g, which were divided into four groups. In rats of the first group, a 5×10 mm liver wound was closed with a fluoroplast-4 fragment, in those of the second – with fluoroplast-4 modified by «Photolon» and calcium chloride, in those of the third - a flap of highly porous fluoroplast-4 was implanted into a 5×5×5 mm hip muscle defect, in those of the fourth - a flap of lowporous fluoroplast-4 was used. The morphology of surrounding tissues and that of an implant were studied at various points of time after surgery using light microscopy and morphometry. Results. Surgical trauma resulting from operation on various tissues followed by plasty using fluoroplast-4 activates a sequence of pathomorphological inflammatory-reparative processes, including three classical stages of inflammation and has a reversible character. Polymer materials act as a framework over which the synthetic material is both isolated by collagen fibers and integrated through the ingrowth of the latter into the pores of the polymer, resulting in the formation of a new connective tissue capsule. Conclusions. Fluorinated polymer materials originally manufactured in the Republic of Belarus are biocompatible polymers that can be used in functionally active areas.","PeriodicalId":34878,"journal":{"name":"Gepatologiia i gastroenterologiia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48142162","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ESOPHAGEAL SQUAMOUS CELL PAPILLOMA. CASE REPORT","authors":"S. S. Celi Simbaña, D. S. Andrade Mora, M. C. Vivar Dávila, S. J. Loza Pavón, V. C. Naranjo Arboleda","doi":"10.25298/2616-5546-2022-6-2-138-140","DOIUrl":"https://doi.org/10.25298/2616-5546-2022-6-2-138-140","url":null,"abstract":"Background. Esophageal squamous cell papillomas are rare epithelial lesions with malignant potential, diagnosed by upper gastrointestinal endoscopy. Their prevalence is from 0.01% to 0.43%. Objective. Description of rare esophageal squamous papilloma diagnosed during upper gastrointestinal endoscopy. Material and methods. A 38-year-old asymptomatic female patient underwent an upper gastrointestinal endoscopy. A growth described as an \"esophageal polyp\" was detected. The biopsy was performed and specimens were sent for histopathological study. Results. The final diagnosis of esophageal squamous papilloma was made due to histopathological study. Because of the malignant potential of these lesions, once diagnosed, early treatment is essential to prevent progression to esophageal carcinoma. Conclusions. Esophageal squamous papillomas are increasing in prevalence and have been shown to be potentially malignant. This argues the relevance of the problem and the need for widespread immunizations to control human papillomavirus infection.","PeriodicalId":34878,"journal":{"name":"Gepatologiia i gastroenterologiia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47160496","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"EFFECTIVENESS OF DIAGNOSTICS AND ROUTINE FOLLOW-UP MONITORING IN CHRONIC HEPATITIS C","authors":"Y. G. Yupatau, V. Semenov, T. Dmitrachenko","doi":"10.25298/2616-5546-2022-6-2-110-114","DOIUrl":"https://doi.org/10.25298/2616-5546-2022-6-2-110-114","url":null,"abstract":"Background. The emergence of new antiviral drugs has made it possible to eliminate the virus in more than 95% of patients with chronic hepatitis C. Improving diagnostics in primary health care aimed at the earliest possible detection of the disease is of primary importance in such a situation. Objective. To analyze the effectiveness of diagnostics and routine follow-up monitoring of patients with chronic hepatitis C in the Vitebsk region. Material and methods. We conducted a retrospective analysis of the incidence of HCV infection in the Vitebsk region during 2009-2020. We performed a comparative evaluation of ELISA and ICA/ICT techniques for the detection of HCV antibody. Results. It was found out that during the analyzed period there was a significant decrease in the incidence of various forms of HCV infection, accompanied by an increase in the proportion of chronic hepatitis C and a sharp decrease in the proportion of anti-HCV carriers, that can be regarded as a direct result of information campaigns designed for primary care providers. There were differences in the structure of HCV infection in various parts of the Vitebsk region. Rapid anti-HCV immunochromatography test showed equal effectiveness with a diagnostic sensitivity of 93.75% (CI = 69.9-99.8) and a specificity of 100% (CI = 82.4-100%) (AUC=0.969, p<0.0001) compared with ELISA. Conclusions. The nosological structure of HCV infection has significant differences in various parts of the Vitebsk region that can be related to diagnostics availability and quality. The use of ICA/ICT for anti-HCV detection during screening is regarded to be more commercially available and economically feasible.","PeriodicalId":34878,"journal":{"name":"Gepatologiia i gastroenterologiia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44570602","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}