[ANALYSIS OF COMPLICATIONS POSTOPERATIVE CAUSES AND MORTALITY AFTER RADICAL TREATMENT FOR TUMORS OF THE LEFT ANATOMICAL SEGMENT OF THE PANCREAS].

Radical surgery for tumors of the left anatomical and surgical segment of the pancreas proved for distal resection in various versions, central resection and enucleation of tumors. The causes of early postoperative complications and mortality in 129 patients aged from 14 to 81 years, operated on for neoplastic lesions of the left anatomical segment of the pancreas in the period from 2009 to 2014 were analysed. The influence of various factors of risk of complications and mortality were studied in particular, extended resection, for tumor invasion of adjacent organs, and adjacent vessels.

[SURGICAL TACTICS IN CHRONIC PANCREATITIS WITH SIGNS OF BILIARY HYPERTENSION].

The results of treatment of 84 patients for chronic pancreatitis with the biliary hypertension signs were depicted. In 83 patients operative interventions were performed, and in 1--positive results were achieved after pancreatic cyst puncture under ultrasonographic control. In 51 patients the conduction of Frey operation have permitted to achieve a lower pressure inside biliary system, in 25--the additional procedures were applied for a biliary hypertension elimination. In 20 patients a method of pressure measurement in biliary system was used.

[SURGICAL TREATMENT OF TUMORS OF THE LEFT PANCREATIC ANATOMICAL SEGMENT].

The results of treatment of 231 patients, suffering tumoral affection of pancreatic left anatomical segment in period of 2009-2013 yrs were analyzed. Individualized approach, using modern technologies, was applied. Radical operations were performed in 129 patients, ageing 14-81 yrs old, including pancreatic distal resections in various modifications, central resection and tumoral enucleation. Possibilities of the extended pancreatic resection performance were studied in conditions of tumoral invasion of adjacent organs, regional vessels, as well as impact of such interventions on postoperative complications and lethality rate. While performing pancreatic subtotal distal resection with simultant resection of affected main venous vessels and adjacent organs the operative intervention risk is enhanced, but possibilities of a radical operations performance in previously considered inoperable patients are expanding.

[Modern insights into the problem of surgical treatment of chronic pancreatitis].

Results of surgical treatment of 290 patients, suffering chronic pancreatitis, were ana- lyzed. Frey's operation was performed in 125 patients, and in 11 - the biliodigestive anastomoses formation was added for biliary hypertension. Pancreaticoduodenal resection was performed in 8 patients, the Bern's modification of Beger's operation and distal pancreatic resection - in 6 for each, longitudinal pancreaticojejunostomy - in 69. In 46 patients, suffering ripe pancreatic pseudocysts, a cystojejunostomy and cystopancreatojejunostomy were performed, in 6 - endoscopic cystogastrostomy and cystoduodenostomy, in 7 - external drainage of the cyst. In 17 patients, suffering duodenal or the biliary system impassability, a bypass anastomoses were formatted.

[Prophylaxis of complications in patients after pancreaticoduodenal resection].

Experience of pancreaticoduodenal resection performance was summarized in 163 patients in 2005-2009 yrs. Duodeno(gastro)enterostomy was formed in anterior position, taking an objective to reduce the risk of postoperative gastrostasis occurrence; and formation of invagination ductojejunal anastomosis--for prophylaxis of pancreatogenic complications. External pancreatic duct drainage and medicinal therapy conduction do not guarantee reduction of the postoperative complications occurrence risk.

[Experience of ASVS-test application in diagnosis of insulin-producing pancreatic tumor].

In 2009-2013 yrs in 7 patients, suffering insulin-producing pancreatic tumors, the ASVS-test was conducted, the result of which was compared with data of standard methods of investigation, including abdominal ultrasound, computer tomography and magnetic resonance imaging. The insuloma enucleation was performed in 3 patients, distal subtotal pancreatectomy with splenectomy--in 1 and the completed total pancreatectomy--in 1. The ASVS-test conduction is indicated in patients with diagnosed hyperinsulinism while impossibility to perform a topic diagnosis of insulinoma, in accordance to data of other noninvasive methods of diagnosis.

[Pancreatic resection using laparoscopic access].

Experience of their own on performance of pancreatic resection interventions, using laparoscopic access, conducted in the clinic in 2009 - 2013 yrs, was presented. In 8 patients laparoscopic distal pancreatic resection was conducted, in 5--laparoscopic enucleation of pancreatic tumor, in 1--laparoscopic pancreaticoduodenal resection. The results were compared with such after open operations, performed in this period of time. There was not a trustworthy difference in the postoperative complications rate, intraoperative blood loss severity and the distal resection duration. The patient stationary treatment duration was trustworthy less after conduction of laparoscopic operations. The intraoperative blood loss severity and duration of laparoscopic enucleation of pancreatic tumor are trustworthy less.