[Surgical treatment of complex external biliary fistula].
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Biomedical subjects
Publications and source records attributed to M M Masalin.
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Surgical treatment of chronic biliopancreatitis has sometimes unsatisfactory results of cholecystectomy and supraduodenal choledochoduodenoanastomosis due to non-eliminated during the operation chronic alterations of the patency of terminal parts of the common bile duct and Wirsung's duct. In most patients with chronic biliopancreatitis good and satisfactory results were noted after performing associated surgical operations including cholecystectomy, transduodenal papillosphincterotomy, wirsungoduodenotomy, correction of duodenostasis and splanchnicectomies.
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The authors describe their observation of 28 patients with extensive scarring stricture of the ductus hepaticocholedochus. The Saĭpol operation was performed in 21 patients, autonomic hepaticojejunostomy with transhepatic change drains in 7 patients. Results of the investigation in the postoperative period have shown the autonomic hepaticojejunostomy to have advantages over the Saĭpol technique.
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On the basis of the experience with the treatment of complicated periampular diverticulum of the duodenum in 12 patients the authors recommend to perform diverticulectomy in combination with transduodenal papillosphincteroplasty, wirsungduodenoplasty and septectomy, which allows reliable suturing of the cervix of the diverticulum ablated and eliminates narrowing of the terminal portions of the common bile duct and Wirsung's duct. The long-term results (from 1 to 3 years) were good.
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