[Acute pancreatitis in primary and metastatic tumors of the pancreas]. / Ostryi pankreatit pri pervichnoi i metastaticheskoi opukholiakh podzheludochnoi zhelezy.

Malignant tumours both of the pancreatoduodenal zone and of other organs situated close to or remote from it occupy a certain place among various etiopathogenetic factors of acute pancreatitis. Complication of the neoplastic process of these organs by acute carcinogenic pancreatitis (ACP) has an effect on the clinical picture of the disease as well as on the therapeutic tactics and the outcomes of the treatment. According to the authors' data (30 patients), ACP occurs in primary carcinoma of the pancreas and in its secondary involvement (metastases and growth of tumours of other organs into the pancreatic tissue). The article discusses the causative factors and clinical forms of ACP, the specific features of their diagnosis and therapeutic tactics. Purposeful nonoperative and operative treatment of ACP makes it possible to reduce the mortality in malignant diseases and prolong the patients' survival.

[Benzoylarginine amidase activity of blood serum and plasma in acute pancreatitis]. / Benzoilargininamidaznaia aktivnost' syvorotki i plazmy krovi u bol'nykh ostrym pankreatitom

In 40 patients with acute pancreatitis, examined 3-2 and 18-24 hours following the onset of the disease, benzoylarginine-amidase activity in blood serum and plasma was determined, as well as the activity of lipase and amylase in blood serum. A correlative dependence was found between the activity of amylase and lipase in blood serum, the activity of amylase in blood serum and trypsin-like activity in blood plasma of patients investigated in different time.

[Resection of the pancreas in necrotic pancreatitis]. / O rezektsii podzheludochnoi zhelezy u bol'nykh nekroticheskim pankreatitom.

The grounds for expediency of pancreatic resection in various periods of the necrotic pancreatitis clinical course are presented together with the description of a simplier technique of a left-side resection of the gland combined with spleenectomy. The left-side resection of the pancreas was carried out in 74 cases, pancreatoduodenal resection--in 1 patient. 4 patients died.

[Acute pancreatitis in the sequestration phase]. / Ostryi pankreatit v faze sekvestratsii

Pathoanatomical, pathogenetic and clinical characteristics of acute pancreatitis in a sequestration phase are given. Under observation were 95 patients with purulentputrid sequestration of the pancreas and retroperitoneal cellular tissue and 20 patients with postnecrotic pancreatic cysts. Some features of the operative treatment in different kinds of sequestration are described.

[Necrosequestrectomy in severe forms of necrotic pancreatitis]. / O nekrsekvestréktomii pri tiazhelykh formakh nekroticheskogo pankreatita.

The authors describe their experience in the surgical treatment of 139 patients with critical forms of necrotic pancreatitis. Operations were fulfilled in 137 of 139 patients. Two non-operated patients died. The article describes in detail the operative technique depending on the character, volume and type of development of the necrotic process. The lowest lethality followed operations in the phase of melting and sequestration due to timely necrosequestrectomy.

[Pathogenesis and clinical significance of fat necrosis in acute pancreatitis]. / Patogenez i klinicheskoe znachenie zhirovogo nekroza pri ostrom pankreatite.

An analysis of results of 200 experiments, 100 autopsies after death from acute destructive pancreatitis and clinical observation of 2000 patients with necrotic forms of acute pancreatitis has given data on pathogenesis of fat necrosis, dynamics of its development, its interrelationships with alterations of the pancreas parenchyma. A concept of unity of proteolytic and steatonecrotic components of acute destructive pancreatitis is substantiated. The authors propose a classification of periods of development of fat necrosis, determine the clinical significance of alterations of the fat tissue at early terms of the disease, give recommendations for the surgical and conservative treatment.

[Acute pancreatitis after intraductal occlusion of the pancreas]. / Ostryi pankreatit posle vnutriprotokovoi okkliuzii podzheludochnoi zhelezy.

The clinical and experimental material has shown that curative intraductal occlusion of the pancreas is followed by the development of acute pancreatitis of different degree depending on the viscosity of the polymer mixture used, degree of filling the duct system of the gland, stimulation of the pancreas secretion and other factors. The curative occlusion should be accompanied by a complex of prophylactic measures.

[Pancreatitis predominantly affecting the caudal part of the pancreas]. / Pankreatit s preimushchestvennym porazheniem khvostovogo otdela podzheludochnoi zhelezy.

The characteristics of specific features of acute and chronic processes in the caudal pancreatis and surrounding retroperitoneal fat is given on the basis of an analysis of 273 cases of pancreatitis with the predominant lesion of this portion. It was established that acute caudal pancreonecrosis at an early period had atypical symptoms and more favourable course than that of the proximal parts of the pancreas. Later periods of the development of this variant of the disease are characterized by great frequency and spread of pyo-necrotic lesion of the retroperitoneal fat. Specific features of the clinical course, diagnosis and treatment were formulated and their being taken into account allowed to reduce lethality of patients with caudal pancreatitis from 39.0% to 25.0%.

[Characteristics of the local pathological changes in acute pancreatitis and therapeutic procedural problems]. / Osobennosti mestnykh patologicheksikh izmenii pri ostrom pankreatite i nekotorye voprosy lechebnoi taktiki.

On the basis of great clinical material (804 patients with pancreatonecrosis) the authors give clinico-morphological characteristics of main components of local pathological changes connected with acute pancreatitis. Debatable questions of the curative methods are described. More exact indications for early surgical interventions are considered in detail.

[Traumatic suppurative-necrotic pancreatitis]. / Travmaticheskii gnoino-nekroticheskii pankreatit.

Among 105 patients with traumatic pancreatitis there were 32 patients with pyo-necrotic pancreatitis. The diagnosis and treatment of pyo-necrotic pancreatitis are described.

[Disorders of microcirculation and systemic circulation in acute pancreatitis and methods of their correction]. / Rasstroistva mikrotsirkuliatsii i sistemnogo krovoobrascheniia pri ostrom pankreatite i puti ikh korrektsii

Clinically (in 186 patients) and experimentally the authors studied the peculiarities of variation in microcirculation, organ blood flow and systemic circulation in acute pancreatitis. The authors emphasize the leading role of early arising circulatory disorders in the pathogenesis of acute pancreatitis. The main pathways for correction of hemodynamic disturbances with due account of their causes, character and the sequence of development are described.

[Thrombohemorrhagic complications of acute pancreatitis]. / Trombogemorragicheskie oslozhneniia ostrogo pankreatita.

On the grounds of a great clinical material (4,800 cases) and autopsy findings (857 autopsies) it is emphasized that there is a pathogenetic relationship between thrombotic complications and hemorrhages common in acute pancreatitis and the main disease; the thrombohemorrhagic complications playing a tremendous part in the development of its most severe forms and fatal outcome. The authors divide these complications inherent in all the phases of pancreatitis into 2 groups: early and late ones, which differ from one another by peculiarities of pathogenesis, clinical picture and treatment. The diversity of the complications is stressed, and recommendations on their diagnosis, prevention and treatment are set forth.