[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.

[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.

[Pancreaticoduodenal resection in the treatment of malignant periampullar tumors].

The experience of performance of pancreaticoduodenal resection (PDR) in 412 patients in 1998-2009 yrs for malignant periampullar tumors was analyzed. In 296 patients a standard PDR was done and in 116, with tumoral affection of distal part of common biliary duct and duodenal large papilla - pylorus-preserving PDR Individualized approach was used, exploiting modern technologies of pylorus-preserving PDR: saving gastroduodenal artery, selective ligation of right branch of dorsal pancreatic and lower pancreatoduodenal artery, dorsal and translateral surgical approaches usage. In 26 patients PDR was accomplished with resection of vessels. In 12 patients a no-touch procedure of PDR was applied. There were analyzed the results of application of modified extended lymphadenectomy while PDR performance. Complications had occurred in 29.5% patients, lethality was 2.7%. The survival indices had constituted at average 24 mo--in pancreatic tumors, 48 mo--in tumors of a distal part of common biliary duct and 72 mo--for localized in duodenal large papilla. Introduction of a new methods of PDR would permit to improve an early and late results of treatment.

[Application of preparations--analogues of somatostatin in surgical pancreatology].

The experience of application of shortly acting and durably acting preparations--analogues of somatostatin in complex therapy of various pancreatic diseases was summarized. There was established similar efficacy of the preparations in blockade of the pancreatic external secretion and the various duration of their inhibiting influence on the blood flow. The trustworthy differences in the complications frequency and lethality while application of various preparations--analogues of somatostatin were not revealed.

[Modern possibilities of chemotherapy in patients with ductal pancreatic adenocarcinoma].

Experience of application of preparation Gemzar as a chemotherapy agent for ductal pancreatic adenocarcinoma was analysed. In 28 patients (main group) chemotherapy using Gemzar preparation was conducted, in 30 patients (control group) chemotherapy was not conducted. The trustworthy differences of life span in patients with unresectable tumors in the main and control groups were noted. Difference of the patients life span after performance of radical pancreatic resection was not trustworthy.

[Application of endoscopic investigation in diagnosis of duodenal major papilla cancer]. / Zastosuvannia endoskopichnoho ul'trazvukovoho doslidzhennia v diahnostitsi velykoho sosochka dvanadtsiatypaloï kyshky.

Endoscopic ultrasonographic investigation (EUSI) was performed in 12 patients with duodenal major papilla cancer, to whom the performance of radical surgical intervention was planned. In 9 patients the diagnosis, according to the EUSI data, was confirmed, in 1--cancer of pancreatic head was diagnosed, in 1--adenoma of duodenal major papilla, in 1--false-negative result was obtained Results of investigation was confirmed intraoperatively and according to the histological investigation data. Application of EUSI have permitted to determine correctly before the operation the stage of the disease in 8 of 9 patients. The method may be applied for verification of the diagnosis in patients with cancer of duodenal major papilla