THE CRYOGENIC TECHNOLOGIES APPLICATION IN THE COMPLEX TREATMENT OF GALLBLADDER ADENOCARCINOMA WITH INVASION INTO THE PORTAL VEIN BRANCHES: CASE REPORT.

The right trisectionectomy is the main treatment modality for locally advanced gallbladder cancer with invasion of the intraparenchymal portal vein branches because it allows the achievement of negative resection margins (R0). However, only 10%-25% of such patients are eligible for surgery. The cryosurgical method has been successfully used in the complex treatment of hepatopancreatobiliary malignant neoplasms for many years.

[SURGICAL TREATMENT OF FOCAL HEPATIC AFFECTION: ANALYSIS OF THE RESULTS AND PERSPECTIVES].

Basing on own material analysis (386 observations) and the literature date there was established, that hepatic resection occupies the first place in treatment of the organ focal affection, together--nontumoral and a tumoral one. The treatment of all kinds of focal hepatic affection must be expanded in a specialized clinic in the Ukraine. The main task of the investigation was to determine a permissible volume of hepatic resection, depending on functional state of the organ parenchyma, improvement of existing and elaboration of a new methods of operative intervention, directed on the complications prophylaxis and the hepatic function preservation.

[DIAGNOSIS OF VASCULAR INVASION BY PANCREATIC TUMORS].

Basing on analysis of own material (84 patients) and data of literature there was established, that vascular invasion by pancreatic tumors constitutes the main obstacle for conduction of the patients' radical treatment. Early diagnosis permits radical resectability of the patients, what constitutes the only one effective method of treatment. In vascular invasion by tumor a surgeon experience and professional preparation determines possibility of the extended operation performance with intervention on affected main vessel, enhancing the treatment radicalism.

[REMOTE RESULTS OF SURGICAL TREATMENT IN PATIENTS, SUFFERING LOCALLY SPREAD FORMS OF MALIGNANT PANCREATIC TUMORS].

Remote results of surgical treatment of patients, suffering locally spread forms of pancreatic malignancies (PM), using different approaches, were analyzed. In retrospective investigation were included 84 patients with PM and invasion of the main vessels. In the group І patients palliative operations were performed, including in a subgroup Іа— cryoablation of PM, in a subgroup Іb — palliative pancreatic resection with leaving the tumor on the main vessels intact; and in patients of group ІІ the tumor was resected radically, including in a sub* group ІІа—pancreatic resection or total pancreatectomy with resection of the main vessels, and in subgroup ІІb — pancreatic resection or total pancreatectomy with cryoablation of tumor, which was left on the main vessel.