[Treatment and prophylaxis of infected forms and complications of pancreatic necrosis with the use of regional intraarterial infusion]. / Lechenie i profilaktika infitsirovannykh form i oslozhnenii pankreonekroza s primeneniem regionarnoi vnutriarterial'noi infuzii.

The aim of the investigation was to study the variants of the course of sterile and infected pancreatonecrosis, the character of the developing complications depending on the state of organic blood circulation in the pancreas and the influence of its correction upon the outcomes of the disease. The material of examination and treatment of 121 patients with pancreatonecrosis was analyzed. Complex treatment of 51 of the patients included the method of regional intraarterial infusion. Celiacography and CT with the intraarterial contrast reinforcement have revealed that in 35 (68.6%) patients there were symptoms of "perfusion block" of the pancreas of different degrees which was due to spasm, thrombosis of the vessels and impairment of the regional microcirculation. Differentiated approach to the composition of the infusate resulted in arrest of phenomena of "perfusion block" of the pancreas in 24 out of 35 patients. As a whole, using this method allowed to reduce the number of purulent complications, primary open operations and reoperations. Lethality in the group with infusion was 9.8%.

[Treatment of complications of pylorus preserving stomach resection]. / Lechenie oslozhnenii rezektsii zheludka s sokhraneniem privratnika.

Causes of unsatisfactory outcomes of pylorus preserving stomach resection are analyzed, method of prophylaxis and surgical correction is proposed. Pylorus preserving stomach resection was performed in 207 patients with chronic gastric ulcer. 2 groups of patients were compared: 166 patients who have undergone pylorus preserving stomach resection by Maky--Gorobashko (group 1); 41 patients operated according to an original method of suprapyloric stomach resection with preserving of distal Latarget nerves on serous-muscular flap formed from lesser curvature of the stomach (group 2). Of 122 examined patients of group 1 excellent and good long-term results according to Visick's criteria were achieved in 101 (82.79%), satisfactory--in 12 (9.84%), unsatisfactory--in 9 (7.37%). Bad stump evacuation due to a stable spasm of the denervated pylorus and hypokinesia of the stump were the main causes of unsatisfactory results. In group 2-39 of 41 patients were examined in long-term period. Excellent and good results were achieved in 38 patients, satisfactory--in 1. There were no unsatisfactory results.