Churpij K. The percularities of diagnostics, tactics and surgical treatment obturational jaundice, complicated acute hepatic insufficiency

The dissertation is dedicated to the diagnostics, pathogenesis of acute hepatic insufficiency and the percularities of surgical treatment of patients with obstructive jaundice of belignant and malignant genesis. In 290 patients the clinical manifestations of obstructive jaundice and their reciprocal link with ultrasound examination data, endoscopic retrograde cholangiopancreatography, regional hepatic blood flow changes, spectrum of protein serum fractions, humoral and cellular indexes of immunity, peroxydation processes and antioxidant protection have been studied. These permit to establish the jaundice genesis, acute hepatic insufficiency in 97 % of patients and work out complex conservative and surgical treatment approach. In patients with acute hepatic insufficiency desiars a two-stages surgical treatment. These permit to prevent the severe postoperative complications and reduce the postoperative mortality. The applying of conservative therapy in pre- and postoperative periods with lactoprotein and sorbitol infusion, reosorbilact, actovegin, sermion, trental, glucose solution with ascorbinic acid, no-spa, immunomodulators permits to prevent or lignidate the acute hepatic insufficiency manifestations.