COMPLEX TREATMENT OF OBSTRUCTIVE-JAUNDICE

The causes of the development of hepatic insufficiency in patients wit h obstructive jaundice after nondosed surgical decompression of the bi liary tract are analysed. The high efficacy of preoperative hemosorpti on in prevention of this complication was demonstrated in experiments on 120 animals. Similar results were obtained in the clinic in 60 pati ents. Five-day treatment with solutions of glucose contrycal (gordox), and sodium thiosulfate improved the results of treatment of obstructi ve jaundice in 600 experimental jaundice, whereas aldactone, prednisol one, sodium oxybutyrate and methacine were poorly effective. In experi ments with prolongation of the preoperative therapy to 8 days the mort ality increased. Glucose, contrycal (gordox), sodium thiosulfate, sodi um oxybutyrate, and aldactone given in the postoperative period increa sed the survival of the animals. It is suggested that the 4-5-day preo perative management of patients with obstructive jaundice should inclu de contrycal (gordox), sodium thiosulfate, and hemosorption applied 24 hours before the operation. Aldactone and sodium oxybutyrate are reco mmended in addition after decompression of the biliary tract. Such tre atment in 162 patients reduced postoperative mortality to 4.4 % in com parison with the control group in which it was 16