[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 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.

[Intraductal papillary-mucinous tumors as a variant of cystic pancreatic tumors. The problems of diagnosis and surgical treatment].

Retro- and prospective investigation of the diagnosis and treatment results of 6 patients, suffering intraductal papillary-mucinous neoplasms (IPMN), was conducted. In 2 patients the central type malignant IPMN were diagnosed, in 1 - the central type of IPMN without malignization signs, in 2 - the IPMN of lateral type without malignization signs, in 1 - the multiple malignized IPMN of lateral type. The magnet resonance cholangiopancreatography, permitted to determine the pancreatic ductal system tumoral involvement, had constituted the main method of instrumental diagnosis. Radical operation was performed in 4 patients (in 3 - pancreatoduodenal resection, in 1 - subtotal distal pancreatic resection), in 2 - palliative operations. Follow-up in radically operated patients in terms from 6 to 21 months showed no recurrence of the disease.

[Peculiarities of diagnosis and surgical tactics in cystic pancreatic tumours].

Results of selective analysis of examination and operative treatment data in patients with clinical diagnosis of cystic pancreatic tumour for ten-year period were presented. The causes of diagnostic and tactic mistakes were analyzed. The volume of necessary methods of instrumental and laboratory diagnosis, indications for operative treatment, volume of which depends on the tumour morphological characteristic, were determined. In serous cystadenoma the tumour excision or economic pancreatic resection is indicated; in mucinous tumour the extended pancreatic resection is indicated.

[An acute necrotic pancreatitis as a complication of cystic pancreatic tumor].

The peculiarities of the cystic pancreatic tumor morphogenesis were studied up. Possibility and probability of the anastomosis existence between mucinous cystic tumor and pancreatic duct with its secondary mucinous dilatation were confirmed, causing the complications occurrence, an acute pancreatitis in particular. Selecting the surgical tactic in mucinous cystic tumor it is necessary to take into account the probability of the intraductal malignization foci formation, what precludes application of extended pancreatic resection using adjuvant chemotherapy and the postoperative serological control conduction.

[Morphological characteristics of cystic pancreatic tumors]. / Morfologicheskaia kharakteristika kistoznykh opukholei podzheludochnoi zhelezy.

The results of 86 clinical observations of cystic pancreatic tumor are adduced. The expediency of the postoperative pathomorphological investigation conduction was substantiated because of high degree of the cystic pancreatic tumors polymorphism presence and low informativity of preoperative and intraoperative investigations.