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For last 12 years 455 patients with an acute pancreatitis were treated in the clinic. In 29 (6.3%) of them purulent pancreatitis, originating from pancreonecrosis, was diagnosed. Operative intervention consisted of laparotomy conduction, bursa omentalis draining through lig, gastrocolicum, excision of purulent-necrotic foci in pancreas and retroperitoneal fat, draining purulent cavity using two silicon tubes, introduced via left and right epigastral regions, durable lavage of purulent cavity with antiseptic solutions. Five patients died.

The results of surgical treatment of 153 patients with diabetes mellitus, suffering from purulent-necrotic complications, were analyzed. The inclusion of parmidin and trental in the complex of treatment have promoted their convalescence and the improvement of microhemocirculation and immunological indexes.

The instrumental methods of investigation data, permitting to estimate the regional hemodynamics state in affected extremity, was used for the lumbar sympathectomy (LS) result prognosis in patients with obliterating atherosclerosis of the lower extremities vessels while chronic critical ischemia. The LS conduction is indicated in patients with critical ischemia in the stage of the regional blood flow compensation if it is impossible to conduct the restorative operation.

The authors report the implantation of two wallstents in a patient by use of the transradial artery approach. This approach for coronary wallstent implantation allows for intensive anticoagulation therapy with less risk of bleeding.

The work substantiates the indications for amputation of the lower limb in patients with obliterating diseases of the vessels. The main among them are progressive gangrene and decompensated ischemia of the limb in impossible performance of a restorative operation. It is pointed out that the level of the amputation should be chosen according to the condition of collateral circulation. Ultrasonic examination based on Doppler effect, allowing measurement of regional systolic pressure, is of principal significance in its evaluation. Analysis of the results of amputations in 111 patients with consideration for the value of regional systolic pressure showed that in 61 (51%) patients the amputation was performed through the leg or foot with immediate favorable results.

Results of treatment of 240 patients with an acute pancreatitis are adduced. Of them 42 (17,5%) were operated on. In 6 patients an acute edema of pancreas was revealed (one patient have died), in 36--destructive forms of an acute pancreatitis, 8 (22%) died. Results of treatment of patients, operated on in one week after disease beginning, were the best.

Reconstructive operations were carried out in the clinic on 437 patients with Leriche's syndrome in the recent 8 years. In 25 of them successive shunting of the vessels of the femoro-popliteal segment became necessary later because of inadequacy of the blood flow immediately after the first operation (15 patients) or consequent thrombosis of the femoral artery (10 patients). Trophic changes in the distal parts of the extremity, pain at rest or intermittent claudication occurring after 20-25 minutes of walking were the indications for resorting to successive shunting in the femoro-popliteal segment despite the maintained functioning of the shunt in the aortoiliac position. The deep femoral artery was used as the donor vessel in 12 operations among the 25 successive operations on patients with the Leriche's syndrome. It is noted that with the use of this vessel the successive operation becomes simpler technically and the length of the shunt can be reduced. Adequate restoration of blood flow in the extremity was attained in all patients after successive shunting of vessels in the femoral segment with the use of the deep femoral artery, and persisted for 6 to 12 months.

The co-operative investigation of two clinics on the basis of examination and treatment of 78 patients with the thoracic outlet syndrome for 5 years is presented. The comparative assessment of the two main methods for surgical treatment--1st rib resection and resection of the anterior scalene muscle has been performed. The results of less traumatic operation of the anterior scalene muscle resection employed in certain forms of the disease are similar to those in performance of more radical operation, the incidence of complications is lower.

Experiments were conducted in 32 dogs to study the results of rheography, ultrasonic Dopplerometry, electric excitability of muscles, and tissue pH measurement in various periods of ischemia and after restoration of blood flow in the extremities. Clinical follow-up of 226 patients with injuries to the major arteries of an ischemic extremity confirmed the importance of the results of instrumental methods of examination for appraising the severity of ischemia and predicting its outcomes. The author distinguished four degrees of ischemia in injury to the vessels. Combination of clinical findings and the results of special methods of treatment makes it possible to choose the rational surgical tactics in traumas of the arteries of the extremities.

The work presents results of measuring the intramuscular pressure in musculus gastrocnemius in healthy people and patients with a pathology of major venous vessels of lower extremities (varicose dilatation of the veins, ++post-thrombophlebitic syndrome with recanalization of profound veins, acute iliofemoral venous thrombosis). It was found that the intramuscular pressure indices correlate with indications of phlebotonometry and may be used for the assessment of the state of venous hemodynamics in lower extremities.

On the basis of examination of 14 healthy people and 23 patients with injured main arteries of extremities it was shown that the Doppler ultrasonic detection was of great importance in diagnosis of injuries of arteries, assessment of the collateral blood circulation and efficiency of reparative vascular operations.

Some problems of surgical treatment of wounds of the proximal portions of the femoral vein are discussed. Considering the development of chronic venous insufficiency, resulting from the ligation of the vein at this level, the necessity of a timely restoration of the main blood flow in such vascular injuries is noted.

The described method of surgical treatment of traumatic aneurysms of the extremities consists in autovenous plasty of the artery following the dissection of the aneurysmal sac and resection of the injured walls of the vessels: after partial resection of the aneurysmal sac walls their remnants are used for covering the vascular graft. The method was applied on 3 patients. The follow-up from 3 months to 3 years has revealed good results.

Operations for recurrent varicosities were made in 48 patients. Extravasal correction of the femoral vein valves, dissection of the popliteal vein aneurysms and ligation of the communicatory veins were also performed in addition to the extirpation of dilated subcutaneous veins.

The suggested method permits to record objectively pressure indices in the collaterals of the extremities in case of occlusion of main vessels. The method helps to get more clear idea on the condition of local hemodynamics in patients suffering from vascular diseases and injuries, which is essential for the choice of treatment.

The author has observed 9 patients with isolated aneurysms of the neck and extremity veins. Clinical manifestations of the disease, diagnosis and surgical methods of treatment are described.