RECENT ADVANCEMENT OF ENDOSCOPIC DIAGNOSIS AND TREATMENT FOR PANCREATO-BILIARY DISEASES

T. YAMAGUCHI

Chiba Cancer Center, Chiba, JAPAN

Recent advancement of endoscopic instrument and technique has remarkably enhanced endoscopic diagnosis and treatment for pancreato-biliary diseases. However, even though its advancement is dramatic, concept and technique are based on endoscopic retrograde cholangip-pancreatography (ERCP). Actual advancements include large balloon Papillary dilatation for biliary stone, endoscopic naso-gallbladder drainage for acute cholecystitis, diagnostic and therapeutic ERCP by using enteroscope (balloon endoscope) for altered gastrointestinal anatomy (e.g. Roux-en Y), etc. Similarly, diagnosis and treatment by endoscopic ultrasonography (EUS) or fine needle aspiration under EUS (EUS-FNA) also has been progressed. We have been investigated the usefulness of contrast enhanced EUS (CE-EUS) with ultrasound contrast agent (Sonazoid ^TM) in the diagnosis of pancreatic diseases. Furthermore, EUS guided biliary duct and pancreatic duct drainage has been developed. In addition, very thin type endoscope enabled to directly examine biliary duct and pancreatic duct (Cholangio-pancreatoscopy).

MINIMALLY INVASIVE SURGERY PULMONARY HYDATID CYST

T.SH. YESHMURATOV, M.M. BATIRKHANOV, M.M. SUNDETOV, P.P. LUKYANCHENKO, N.S. JARILKAPOV, A.M. EELEUSIZOV

National Scientific Center of Surgery named after A.N.Syzganov, Almaty, KAZAKHSTAN

The aim of the study.Improvement of the results of surgical treatment of patients withtwo-sided pulmonary echinococcosisby the development of sparing, invasive, nontraumatictreatment methods.

Materials and methods.Comparative analysis of results of surgical treatment of 73 patients with echinococcosis of both lungs was conducted, the age of patients ranged between 3 - 74 years, there were 38 (52%) men, and 35 (48%) – women among the examined.

Results and discussion.To reduce traumatism of surgery, duration of the operation and postoperative period, risk of such postoperative complicationsas respiratory failure there were developed methods of surgical treatment of pulmonary hydatid cyst: one-sided thoracotomy, one-stage two-sidedechinococcectomy with the use oftransmedial access, two-sided one-stage bilateral videothoracoscopy with echinococcectomy of both lungs . Patients were divided into two groups according to the terms of operative inverventions: the main group - 40 (54.8%) patients, they were performed one-stage successiveechinococcectomy of lungs, it consists of 3 subgroups (subgroup 1 - 20 (27.4%) patients, they were performed two-sided single-stage successive thoracotomy, echinococcectomyfrom the lungs, 2 subgroup - 11 (15.1%) patients, they were performed one-sided thoracotomy, and mediastinotomy and echinococcectomyof both lungs, 3^rd subgroup - 9 (12.3%) patients, after a twi-sided one-stage, successive thoracoscopy, echinococcectomyfrom the lungs), control group - 33 (45.2%) patients that underwent two-stage surgery with an interval of 3-4 weeks.

Conclusion. Improved methods of one-stage surgical treatment of bilateral injury of lungs with hydatid cysts with the use of transmedial and videothoracoscopic method allow in all cases to reduce the duration of operation and duration of the postoperative period, as well as to reduce the financial costs of treatment.

Date: 2014-12-28; view: 715