[Cystic tumors of the pancreas]. / Kistoznye opukholi podzheludochnoi zhelezy.

Thirty-three patients were operated on for cystic tumors of the pancreas at the Vishnevsky Institute of Surgery in 1980-90. Cystadenoma of the pancreas was found in 16 (48.5%) of them and cystadenocarcinoma in 15 (45.5%). Fifteen (45.5%) patients had been previously operated on in different institutions presumably for a "cyst" of the pancreas, 6 of them repeatedly; the tumor recurred rapidly in all of them. In the Institute 30 patients underwent radical operations: 30 distal resection of the pancreas and 5 pancreatoduodenal resection. Diagnostic and palliative manipulations were performed on 3 patients. Postoperative lethality was 9.1% (3 patients). Postoperative follow-up periods lasted from 12 months to 9 years. Dissemination of the tumor occurred in 2 patients two years after the operation. The remaining 25 patients are alive and capable of working.

[Problems in the surgical treatment of pancreatic chronic diseases]. / Problemy khirurgii khronicheskikh zabolevanii podzheludochnoi zhelezy.

The work analyses the results of 999 operations on the pancreas conducted in 861 patients with chronic oncological and nonneoplastic diseases of the gland. Pancreatoduodenal resection (PDR) was performed in 171 patients (for tumors of the pancreaticoduodenal zone in 151 and for chronic pancreatitis of the head of the gland in 20) in 13 of them a modified operation with preservation of the stomach and pylorus was carried out. The late-term results were satisfactory in both groups of patients, the survival of oncological patients was much higher after radical operations then after palliative surgery. Total duodenopancreatectomy has no advantages over PDR and should be undertaken only when there are strict indications. In chronic pancreatitis, complicated also, preference was given to organ-preserving interventions, primarily to draining operations, which preserve more fully pancreatic exocrine and endocrine functions: longitudinal pancreatojejunostomy was conducted in 106 patients, internal drainage of pancreatic cysts in 184, and occlusion of external pancreatic cysts in 70 patients. It is advisable that the most complicated, particularly repeated and reconstructive, operations on the pancreas are carried out at specialized centers in which the problem of surgical diseases of the pancreas is studied more closely.