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The authors analyzed an experience with treatment of 4372 patients. Videothoracoscopy allowed the number of usual drainages of the pleural cavity to be reduced in closed trauma from 16.3% to 2.3%, in wounds--from 3.9% to 0.4%. Persistent hemo- and airstasis were obtained by coagulation of the vessels of the thoracic wall and lung, suturing lung wounds. The coagulated hemothorax was removed, diaphragm wounds were sutured, the pericardium wounds were revised, the character of intrathoracic lesions was reliably determined in 98% of cases. Conversion into thoracotomy was fulfilled in 91 (5.5%) patients. Thoracotomy was fulfilled in 344 (8%) patients with indications to operative interventions and severe condition and unstable hemodynamics. The number of thoracotomies and lethality in patients with penetrating wounds of the chest became 1.5-2 times less, was not considerably changed in closed traumas.

A new original instrument is proposed for draining the cystic duct into the common bile duct through the stump. The device combines a reliable fixation of the drainage tube in the stump of a narrow (less than 3 mm) or scared altered cystic duct and the not traumatically embedded cannula into the common bile duct.

The authors have analyzed results of thoracovideoscopy in 45 patients with the syndrome of pleural exudate, 17 of them had undergone the ultrasonic examination of the pleural cavity before thoracoscopy. The examination has revealed high sensibility of the ultrasonic method in the diagnosis of fragmentations of pleural exudate and pathology of the pleural leaves. The endoscopic and echographic classification of the pleural exudate is given depending on the fragmentation degree. The authors consider that echography of the pleural cavity as a noninvasive and highly informative method should be included in the first rank in making an algorithm of clinico-diagnostic measures for patients with exudative pleuritis.

Specific electrical conductance (SEC) of the hepatic bile in 94 patients with cholelithiasis and concomitant pancreatitis was increased (p < 0.001) and depended on the degree of cholestasis and the morpho-functional state of the liver. The value of SEC of the intraoperative bile higher than 193 S/m is taken for a criterion of the diagnostics of biliary pancreatitis. The electrical conductance of urine during the first 4 days of observation decreased in patients with acute pancreatitis (p < 0.05), impaired carbohydrate metabolism and concomitant renal dysfunction. The value of SEC of urine lower than 238 S/m corresponds to acute pancreatitis. The investigation of physico-chemical indices of biological liquids in patients with a pathology of the pancreato-biliary system allows to objectively control the course of the disease and to correct the treatment methods.

An analysis of surgical treatment of 142 patients with cancer of the colon and rectum included 32 emergency cases and 110 scheduled operations. Standard surgical methods only were used in 94 patients, the lymphotropic immunocorrection with myelopidum in the postoperative period was made in 48 patients. The use of lymphotropic immunocorrection was shown to considerably improve the immunological parameters and to decrease postoperative lethality.

The article is devoted to the problem of diagnosis and treatment of 28 patients with cranio-cerebral injury with posttraumatic fat embolism. In 15 of them fat liquoroglobulia was diagnosed which is a reliable symptom of the cerebral form of fat embolism. The method of detection of fat liquoroglobulia is described. A new method--liquorosorption--was used in treatment of patients with the cerebral form of fat embolism. A disturbance of the hematoencephalic barrier is thought by the authors to be possible in such embolism.

The article is devoted to the problem of fat embolism. In 63 patients with combined and isolated traumas the maximum frequency of fat embolism was diagnosed in the investigation of blood serum from the femoral artery. It can be supposed that no isolated injury of the lesser circulation circuit can occur in fat embolism. An investigation of the venous-arterial difference of fat globulemia has shown the main role of the so-called theory of shunting for fat embolism to be doubtful.

An experience with using endovascular venous embolization in 53 patients with bleeding from varices of esophageal veins is presented. Transhepatic, transsplenic and laparotomic accesses were used. Embolization of the gastric veins was fulfilled with nonlysing materials--teflon velour in combination with metallic spirals. The results obtained proved to be better than those known from the literature.

The authors have developed a method for transcutaneous transsplenic catheterization of the portal vein basin and used this method in clinical studies. This method permits a higher quality of spot splenoportography, selective catheterization and embolization of the gastric veins in bleedings from varicose veins of the esophagus in the patients in whom catheterization of the portal vein bain via the transcutaneous transhepatic approach is impossible because of liver tumors of occlusive stenotic deformation of the portal vein.

The article generalizes materials of 148 rethoracotomies. Main complications are described. Grounds are given for the use of perfusion through the xenospleen at the early postoperative period in order to liquidate the coagulated haemothorax mainly after pulmonectomy. An original method of determination of the coefficient of relative viscosity of the exudate on the absorbing base is described. The method allows the objective control of infectivity of the pleural exudate to be performed. The clinical use of different methods of detoxication in the preoperative period is substantiated: UVI of blood, hemocarbosorption and xenohemosorption, which allowed to reduce lethality after rethoracotomies and reoperations on the lungs.

Endovascular occlusion of the veins which carry the retrograde outflow of blood from the portal system into the system of the superior caval vein through the varicose dilated esophageal veins is known to be one of the most effective methods to stop profuse bleedings due to a disturbed integrity of the varicose dilated veins of the esophagus. It is thought to be expedient to add injections of thrombin to embolization. When performing embolization of the splenic artery it is necessary to exclude possible development of the resulting collateral blood flow via the spleen.

Questions of the application of paracentetic transhepatic catheterization of the portal vein performed from the lateral access are dealt with. Indications for its application are discussed. Morphological changes and disturbances of hemodynamics of the portal system in certain diseases of the abdominal cavity are analyzed. Possible application of catheterization of the portal vein with curative purposes in order to stop oesophageal hemorrhages in portal hypertension and for continuous antienzymatic therapy of pancreonecrosis is shown.

A technique of the external, external-internal and internal drainage (endoprosthesis) of bile ducts is described in detail. It was used in 75 patients with different diseases of organs of the hepato-pancreato-duodenal area. The method of the percutaneous transhepatic drainage and endoprostheses of bile ducts was standardized, the instruments necessary for transhepatic interventions on the biliary system being also determined.

An analysis of complications after performing a transhepatic catheterization of the portal vein in 117 patients with different diseases has shown that all of them were associated with mechanical traumas of the liver parenchyma, vascular structures or bile ducts and may be considered to be a direct consequence of technical problems and errors. The most severe complication of the procedure was bleeding into the abdominal cavity. Certain technical means facilitating the examination and improving its safety are discussed as well as methods to prevent bleedings into the abdominal cavity.

The arterial catheter embolization was used in 11 of 14 patients with profuse gastroduodenal hemorrhages. The results showed high efficiency of the method. The described method, the level of the occlusion thus obtained allowed avoiding possible complications and gave good hemostatic effect. The authors discuss the indications for the endovascular catheter embolization. An original method of embolization of the left ventricular artery is described.

Data of 25 patients are described who were subjected to the occlusion of the internal and external iliac, renal and splenic arteries. Results of the interventions are discussed. The authors make an analysis of complications resulting from the application of coils and recommend methods for their prevention.