Biomedical subjects
Publications and source records attributed to A I Gontar'.
The experience of treatment of 65 patients with cancer of the gall bladder (CGB) is analyzed. The tumor was revealed in women 7.2 times more often than in men. 95.3% patients were older than 60 years. Diagnosis of CBG is difficult before and during operation. Retrograde cholangiopancreatography increases reliability of diagnosis. The survival after radical cholecystectomy was 23.3 months.
Cystic entropium is a rare surgical pathology. Not more than 300 descriptions of such clinical cases in adults could be found in medical journals, and isolated cases-in children. The diagnosis of cystic entropium appears to be difficult because of the lack of pathognomonic symptoms. Visual examination and palpation may be helpful in diagnosis in children (the examination should be done under raush narcosis). A clinical case of gallbladder entropium in a child of 1 year and 9 months of age is reported. The disease was complicated with necrosis of the bladder. A favorable outcome of the disease was demonstrated. The peculiarity of the case was in atypical infraliver location of the appendix, that had signs of secondary changes.
From 1976 to 1987, 1,537 operations were carried out for cholecystitis at the Ramensk District Hospital; carcinoma of the gallbladder was found in 27 patients, one case with carcinoma of the gallbladder was recognized during laparoscopy and another case during autopsy. Twenty-five patients were over 60 years of age. Concrements were discovered in 16 patients. The diagnosis of carcinoma of the gallbladder cannot be established sometimes, even during an operation. For instance, the authors were able to recognize it in 10 cases only after histological examination. Radical cholecystectomy could be carried out only in 6 of 27 patients. Three of them died having survived 360 days, on average, after the operation. Two patients were alive for more than 4 years, one patient for over 7 years. The average survival of 10 patients after laparotomy and biopsy was 46.5 days. The survival of 11 patients treated by palliative operations was 56 days on average.
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