Diagnostic approach and treatment specificity in patients with focal lesions of the biliopancreatic area complicated by mechanical jaundice.

Pancreatoduodenal resection (PDR) represents one of the most demanding procedures which is required in patients with a tumoral lesion at this level. The aim of the present article was to report the results of 272 patients submitted to such surgical procedures. All patients were divided into two groups: the main group, for whom the optimized decompression algorithm was used (n=112) and the control group, for whom preparation for PDR was carried out according to generally accepted standards (n=160).

[Functional state of the hemostasis system in patients, operated for pancreatic pseudocysts].

Operative treatment of pancreatic pseudocysts coincides with the indices of the blood coagulation system change, which are characterized as a hypercoagulative. These disorders are noted in 12-24 h postoperatively, their rate is reducing substantially while application of pentoxyphylline. Most significant lowering of intraoperative hypercoagulation was noted while application of endoscopic drainage with the pseudocysts cavity stenting.

[Comparative efficacy of various variants of pancreaticoduodenal resection according to the results of early postoperative period].

Pancreatoduodenal resection (FOR) was performed in 131 patients: in 105--for pancreatoduodenal zone cancer and in 26--for fibrous chronic pancreatitis. The elaborated procedure for pancreatojejunoanastomosis formation, performed on reconstructive stage of PDR, secures the total complications rate lowering, comparing with such in conventional procedure with end to end aniastomosis suturing and after terminolateral anastomosis formation in 1.42 and 1.

[Comparative efficacy of pancreatoduodenal resection using intraoperative cryo-techniques].

In 61 patients pancreaticoduodenal resection (PDR) was performed: for pancreatic gland head cancer-in 29, periampullar zone cancer--in 20, chronic pseudotumoral pancreatitis--in 12. In 10 patients, suffering pancreatic gland and periampullar zone cancer, complicated by solitary hepatic metastases, PDR was added by cryodestruction of metastases. Cryoaffection on pancreatic gland stump during PDR performance have resulted in lowering of early postoperative complications frequency (pancreatic fistula, parapancreatic septic inflammation and an acute pancreatitis) and of chronic pancreatitis acute phase evolvement risk in the late postoperative period.

[Performance of simultaneous operations in surgery].

The experience of conduction of simultaneous operations in 183 patients is summarized. The indications and advantages of their application are substantiated.