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The OBJECTIVE was to study the efficacy and safety of laparoscopic decompression of the celiac trunk.METHODS AND MATERIALS. A comparative analysis of the results of laparoscopic (30 patients) and conventional decompression of the celiac trunk (50 patients) was carried out. All patients were operated on between September 2018 and July 2021.RESULTS. Intraoperative bleeding during laparoscopic decompression of the celiac trunk, which required conversion of access to laparotomy and vascular suture, was noted in 2 (6.7 %) cases. With conventional access, there were no such complications. The average duration of laparoscopic decompression of the celiac trunk was 107 minutes, from conventional access – 150 minutes. The average length of hospital stay after laparoscopic intervention was 4 days, after the traditional one – 7 days. Long-term results of treatment over a period of more than 6 months were evaluated in 28 patients who underwent laparoscopic decompression of the celiac trunk and 45 people who underwent conventional decompression. Ultrasound examination in all cases stated the return of linear and velocity parameters of blood flow in the celiac trunk to normal. complete relief of the clinical manifestations of the disease was achieved in 24 (85.7 %) patients after laparoscopic and in 39 (86.7 %) after traditional intervention.CONCLUSION. Laparoscopic decompression of the celiac trunk is an effective method of surgical treatment of the syndrome of compression of the celiac trunk, but there are risks of vascular damage. The long-term results of laparoscopic and open decompression of the celiac trunk are comparable.

The article is devoted to the history of gastric surgery in Saint Petersburg (Russia) in the XIX century. In the last decades of the 19th century, there was a breakthrough in surgery - surgeons from all over the world began to operate on the stomach. For the first time in Saint Petersburg and in Russia, Russian surgeons M.K. Kitaevsky, D.M. Monastyrsky and N.V. Ekk performed stomach resection for cancer by Billroth I method (M.K. Kitaevsky, 16.07.1881) and gastroenteroanastomosis for cicatrical pyloric stenosis (N.D. Monastyrsky, 13.03.1882), and at the meeting of the Society of Russian Doctors in Saint Petersburg in May 1882, V. Ekk proposed to overlap an anastomosis between the stump of the resected stomach and the loop of the small intestine that was realized by the Viennese surgeon T. Billroth only 3 years later in 1885, and got the name of the modification of gastric resection by the Billrot II method. It should be noted that M.K. Kitaevsky and N.D. Monastyrsky worked at Petropavlovsky Hospital - on the basis of which the Women's Medical Institute was established in 1897 (now the Pavlov First Saint Petersburg State Medical University).

В статье отражена роль академика РАН Ю.Л. Шевченко в развитии отечественного здравоохранения.

Introduction. Currently, traditional methods and minimally invasive surgical technologies are used in the treatment of celiac trunk compression syndrome. The choice of treatment method remains a subject of discussion. The drawback of the classical approach – laparotomy – is a significant trauma to the tissues of the abdominal wall, the risk of adhesions, wound infection and hernias. The disadvantage of videosurgical techniques is the risk of developing life-threatening bleeding requiring conversion of access. The main cause of this complication is damage to the wall of the aorta, celiac trunk and its branches during the intervention.Methods and materials. A set of tactical and technical principles was developed to reduce the risk of bleeding during laparoscopic decompression of the celiac trunk. The prerequisites were an assessment of the individual architectonics of the vessels according to 3D reconstruction data, the location of working instruments as parallel to the celiac trunk course, retrograde access to the compression zone, the use of an ultrasonic or bipolar dissector, contact with the vascular wall only with passive branches. With these principles surgical intervention was performed in 12 patients.Results. Complication (bleeding from the branch of the lower phrenic artery) – occurred in one (8.3 %) case – was eliminated laparoscopically. The average duration of the operation was 85 minutes, the average hospital day after the operation was 5 days. Treatment results within 3 to 12 months were evaluated in 8 out of 12 (66.7 %) patients. In 7 (87.5 % of patients with the studied results) cases, complete regression of symptoms and restoration of normal blood flow were noted. One (12.5 %) person had a slight abdominal pain syndrome against the background of normal hemodynamics in the celiac trunk.Conclusion. The presented data are comparable with the results of traditional surgical methods of treatment of celiac trunk compression syndrome and are the basis for further research.

The objective was to improve the management of patients with acute biliary pancreatitis against the background of cholecystocholedocholithiasis.Methods and materials. 107 patients with acute biliary pancreatitis against the background of cholecystocholedocholithiasis were treated between 2017 and 2020 years. Patients suffering from mild and moderately severe acute biliary pancreatitis underwent single-step (laparoscopic cholecystectomy with endoscopic papillosphincterotomy) or two-step (endoscopic papillosphincterotomy with delayed laparoscopic cholecystectomy) surgical interventions. Patients with severe acute pancreatitis underwent endoscopic papillosphincterotomy with or without common bile duct and pancreatic duct stenting. The comparative analysis was made to estimate the efficiency of different surgical interventions in different groups of patients.Results. Patients with mild or moderately severe acute biliary pancreatitis showed better outcomes after single-step surgical intervention. Patients with severe acute biliary pancreatitis – after endoscopic papillosphincterotomy with common bile duct and pancreatic duct stenting.Conclusion. Single-step surgical interventions (laparoscopic cholecystectomy with endoscopic papillosphincterotomy) are shown for patients with mild or moderately severe acute biliary pancreatitis, because this approach helps to preserve the complications, specific for two-step interventions. The single-step approach authentically helps to decrease the duration of hospital stay and reduce treatment costs. The two-step approach is shown for patients with severe acute biliary pancreatitis, but endoscopic papillosphincterotomy with lithoextraction should be supplemented by common bile duct and pancreatic duct stenting, in order to reduce the number of complications associated with delayed cholecystectomy.

The article is dedicated to the memory of the Russian surgeon, prominent scientist, public health organizer and the founder of the first Russian periodical surgical journal of N. A. Vel’jaminov in 1885, who was born 165 years ago and died 100 years ago.

To treat the patient with Achalasia and prevent the symptoms of gastroesophageal reflux the Peroral Endoscopic Myotomy with Simultaneous Endoscopic Fundoplication was done by the current authors. After performing a myotomy the endoloop was fixated to the stomach and was attached to the muscle of the esophagus by using the endoclips. The endoloop was tightened therefore shaping the cuff. This operation has been technically feasible and no immediate or delayed complications occurred.

OBJECTIVE. The authors aimed to develop complex perfusion medical device in order to successfully maintain viability of donor liver until transplantation. MATERIAL AND METHODS. Experimental perfusion device for normothermic perfusion donor’s liver was developed and tested in the Central Research and Experimental-design Institute of Robotics and Technical Cybernetics. RESULTS. The pre-clinical tests were performed on porcine liver. It was demonstrated that normothermic machine perfusion could restore liver function after 30 minutes of warm ischemia time and provide normalization of biochemical parameters of organ functioning.

OBJECIVE. The authors would like to design an original device for aerosol laparoscopic chemotherapy and propose the most effective and safe mode. MATERIALS AND METHODS. The experimental and clinical studies were carried out and included 6 series. Male rabbits (n=71) were used for experimental part and the method was applied on 4 patients in clinical part. RESULTS. The original device and the effective mode of its application were developed for aerosol laparoscopic chemotherapy. The supposed method of chemotherapy appeared to be more effective than the standard method. There weren’t noted any complications or side effects. The method proved its safety. CONCLUSIONS. The aerosol laparoscopic intraperitoneal chemotherapy using the proposed regime is the effective and safe method of peritoneal carcinomatosis treatment.

The article presents the assessment results of efficacy of modern bariatric laparoscopic operation during 10 years of practice. This work analyzed the treatment results of 1018 operated patients at the period from 2007 to 2014. The laparoscopic regulated gastric bandage operation was performed in 275 (28, 8%) cases. The lapa roscopic longitudinal gastric resection (LLGR) was applied in 411 (43,1%) (231 operation used the developed modification and 180 used standard method). The laparoscopic gastric bypass surgery (LGBS) was carried out in 253 (26,5%) cases (56 used the developed modification and 197 used the Lontron modification). The laparoscopic biliopancreatic bypass surgery (LBBS) was made in 14 (1,4%) cases (11 used Hess Marceau Baltasar modifications and 2 - Fobi modification, 1 - Scopinaro operation). BIB was implanted in 65 (6,3%) cases. The diagnosis of metabolic syndrome had initially been established for 321 (31,5%) patients. The rest of the patients 697 (68,4%) have been operated for obesity of different degree. An initial body mass index (BMI)

Antireflux resection of mucous membrane of esophagogastric anastomosis (ARMS) was performed on 6 patients with typical symptoms of gastroesophageal reflux disease (GERD). The patients had a short segment of сolumnar-celled metaplasia (1-2 cm) without radiological and endoscopic signs of hiatal hernia. All the patients received medicamentous therapy by antisecretory agents more than 3 years. The operation included the endoscopic resection of2/3 circle of mucous membrane of esophagogastric anastomosis and resection of the area of columnar-celled metaplasia. The results of treatment were assessed during 3-7 months after ARMS. There was noted an absence of clinical manifestations of GERD, regression of inflammatory signs of mucous coat of esophagus in 4 out of 6 patients. Symptoms of GERD remained in 2 patients, although the intensity of signs significantly decreased.