Dmytro Dubenko
@nmuofficial.com
Surgery department
Bogomolets National medical university
EDUCATION
Bogomolets National medical university
National University of "Kyiv-Mohyla Academy"
RESEARCH, TEACHING, or OTHER INTERESTS
Surgery
Scopus Publications
Scholar Citations
Scholar h-index
Scopus Publications
Igor Khomenko, Ievgen Tsema, Kostiantyn Humeniuk, Heorhii Makarov, Dmytro Rahushyn, Yurii Yarynych, Artur Sotnikov, Viktor Slobodianyk, Serhii Shypilov, Dmytro Dubenko,et al.
Oxford University Press (OUP)
ABSTRACT The combat penetrating gunshot injury is frequently associated with damage to the liver. Bile leak and external biliary fistula (EBF) are common complications. Biliary decompression is commonly applied for the management of EBF. Also, little is known about the features of combat trauma and its management in ongoing hybrid warfare in East Ukraine. A 23-year-old male was diagnosed with thoracoabdominal penetrating gunshot wound (GSW) by a high-energy multiple metal projectile. Damage control tactics were applied at all four levels of military medical care. Biliary decompression was achieved by endoscopic retrograde cholangiopancreatography (ERCP), endoscopic sphincterotomy (EST) and the placement of biliary stents. Occlusion of the stent was treated by stent replacement, and scheduled ERCP was performed. Partial EBF was diagnosed from the main wound defect of the liver and closed without surgical interventions on the 34th day after the injury. A combination of operative and nonoperative techniques for the management of the combat GSW to the liver is effective along with the application of damage control tactics. A scheduled ERCP application is an effective approach for the management of EBF, and liver resection could be avoided. A successful biliary decompression was achieved by the transpapillary intervention with the installation of stents. Stent occlusion could be diagnosed in the early post-traumatic period, which is effectively managed by scheduled ERCP as well as stent replacement with a large diameter as close as possible to the place of bile leak.
P. F Muzychenko, V. A Chernyak, S. I Savosko, Yu. N Lankin, K. K Karpenko, D. E Dubenko, Yu. V Nahaliuk, V. U Zorgach, T. I Manzuk, R. V Gybalo,et al.
SciELO Agencia Nacional de Investigacion y Desarrollo (ANID)
assessment of vascular anastomoses performed using high frequency SUMMARY: The studies of the properties of vascular structures and tissues during electric welding, in particular direct morphological changes in the blood vessel walls in the areas of welding processes, are of interest. Perforating veins, femoral veins, abdominal aorta, vena cava and porcine perforating veins of the limbs were used in this study. We performed end-to-end electric welding of the aorta, venous end-to-side electric welding, vein end-to-artery side arterial and venous welding, venous end-to-end electric welding, as well as arterial and venous lumen sealing.The results of histological studies showed the formation of a coagulated acellular protein matrix, represented by unorganized denatured protein fibrous structures. In the area of vascular tissue coagulation, lacunes were formed as a result of water evaporation from the biological tissue. In the perifocal area of the welded junction, cell reduction occurred without necrosis or charring. The data obtained confirm the safety of high frequency electric welding of the main vessels and the prospectfor clinical use of the studied techniques.