Data concerning history of hepatic surgery beginning from the Middle Ages to current days are presented. On the first stage (till XIX century), representatives of medical profession had schematic ideas on hepatic anatomy and operations on this organ were perforemed sporadically. On the second stage (first half of the XX century), segmental hepatic anatomy was established, different technical methods concerning identification of shared and segmental pedicles were offered. Planned resections of the liver began to be regularly performed in this period. Current, third stage of the surgery development was marked by the synthesis of achievements in the area of hepatic anatomy and surgery with revolutionary discoveries in high technology area, immunology, tissue compatibility and pharmacology. Such surgeries became to be possible as transplantation of the liver, broadened resections and extracorporeal interventions performed on the liver.

Results of 325 major liver resections were investigated. The common indications were malignant and benign lesions, hydatid cysts, purulent cholangitis, posttraumatic liver necrosis. The main complications after liver resections were massive intraoperative bleedings and acute postoperative liver failure. The main causes of blood loss and liver failure were discovered. The most effective means to prevent bleeding was anatomical liver resection. Lobe vascular occlusion is essential for minimal blood loss. Postoperative liver failure was strong associated with the small volume of the remnant liver and decrease in functional liver capacity. Precision selection of patients and preoperative portal vein embolisation lead to decrease the rate of liver failure (5,4%).

purpose of this study is to evaluate the results and role of radical operations in the management of hepatic hydatid disease. 317 patients with liver hydatid cysts underwent surgical treatment. Liver resection, total and subtotal pericystectomy were possible in 215 patients (67,8%). There were 115 patients (36,3%) with complicated hepatic hydatid cysts. Residual echinococcosis was indication for operation in 17%. Among all patients 53 (16,7%) presented other anatomic sites of parasite such as lung, peritoneum, kidney, and other viscera. The postoperative complication rate was 25,7% after operations without pericystectomy, 17,6% - after radical operations and 19,8% - after combined operations. The mortality rate was 1,6%. The recurrence rate was 6,7%. Removal of cystic and pericystic tissue and liver resection are the only type of operations for safe and radical treatment of liver hydatid cysts, especially in the cases of complicated and relapsing disease.

To develop the optimum medical-diagnostic algorithm, allowing to lower the lethality and frequency of complications at patients with acute cholangitis and biliary sepsis. To define interrelation and to reveal distinctions between acute cholangitis and biliary sepsis. Patients with acute cholangitis and biliary sepsis of various severity and etiology; cases history. Development of the given problem will allow to lower lethality at purulent cholangitis and biliary sepsis.

The present research is based on the analysis of 500 patients with liver cirrhosis with complicated portal hypertension. All patients were examined and operated in the department of portal hypertension and pancreatic-duodenal zone surgery of acad. V. Vakhidov Republican Specialized Surgery Centre (Tashkent) during the period of 1976 - January 2007, included. The appreciation of survival rate curve in patients with liver cirrhosis after portal-systemic shunting is given on the basis of the prognosis factors stratification, that predetermines individual approach to each patient in the choice of surgical tactics and rehabilitation actions. We have mostly studied results and efficacy of different variants of portal-systemic shunting in stratificated groups, that allowed to reveal the most favourable group of patients with LC in respect of long-term prognosis after portal-systemic shunting.

The experience of planned treatment more than 2 000 patients with chronic duodenal ulcer makes it possible to work out the diagnostic algorithm, based on complex research of acidic stomach secretion. The principles of choosing of interference (organ-retaining, resecting or combining interference) and kind of pyloroplasty were defined. The right choice of operation of complicated duodenal ulcer secures excellent and good results for 85% patients.

The experience of surgical treatment of 154 patients having chronic pancreatitis with preferential injury of the pancreas head which underwent different operative interventions: isolated resection of pancreatic head ( based upon Berger surgery - 24, Frey surgery - 39), pancreatoduodenal resection ( with gastric resection - 22, with preserved pylorus - 43) and drainage surgeries - 26 is presented in the article. The surgery of isolated resection of pancreatic head has less number of nearest unfavorable results compared with pancretoduodenal resection with preserved pylorus. Proximal resection of the pancreas the variants of which are different isolated resection of pancreatic head is superior upon surgeries with full or partly resection of the duodenum due to fast normalization of the motor-evacuation function, less rate of the intestinal reflux and portion character of duodenal evacuation. In the follow-up period after pancreatoduodenal resection, atrophic processes occur in distal areas of the pancreas which are followed by clinical manifestations of exo- and endocrinous insufficiency. The surgery of longitudinal pancreatic jejunostomy does not avoid pathologic changes in the organ head and pain syndrome.

Seven years experience of liver resection in living related donors for orthotopic transplantation in patients with end-stages diffuse and focal diseases of the liver is summarized. Basic principles of donor selection, surgical technique and postoperative course were studied in 104 cases of right and left liver graft harvesting. The postoperative incidence consisted of hemorrhage - 1 (1,1%), hernia - 1 (1,1%), bile leakage - 3 (3,3%). All donors survived with full medical and social rehabilitation.

The results of surgery in the group of patients with incisional hernias are evaluated. Hernioplasty with polypropylene mesh was performed in 22 patients. Electromyography was performed for abdominal wall muscles function estimation. High effectiveness of surgical treatment was established.

Duodenal dystrophy, a chronic inflammation of the aberrant pancreatic tissue in the duodenal wall, is a relatively rare disease in the practice of physicians. The heterotopic pancreas is usually functioning, and the development of acute and chronic pancreatitis in it is even more probable than in the orthotopic gland as a result of an underdeveloped duct system. The progression of ectopic pancreatitis associated with increasing cystic formation could lead to a blockade of the major or minor duodenal papilla and subsequent chronic pancreatitits in the pancreas proper. Furthermore, a malignant transformation of the aberrant pancreas is not a rare occurrence. It is essential to carry out a timely and sharp diagnosis of this condition as it often defines the surgical tactics. The purpose of this report is to present a typical case of cystic duodenal dystrophy.

Here are represented our results according to making and clinical using of different TiNi devices for treatment of digestive system diseases. Constructions for perfoming of compression anastomoses, cliping of tubular structures during laparoscopic operations and perforated ulcer plastic. Materials of experimental investigations and clinic experience of 220 cases treatment are represented.

The original techniques of the separation surgery in the system of portal and azygos veins in patients having portal hypertension and esophageal varicosis with recovery of the valve apparatus in the area of gastroesophageal junction is offered in the article which allows to avoid the development of reflux-esophagitis and recurrence of esophageal bleeding in the postoperative period.