Complex treatment of multiple high-output enterocutaneous fistulas (gastric, jejunum, transversum) after bariatric surgery.

Multiply high-output enterocutaneous fistulas (ECF) is a tragic postoperative complication. This report describes complex treatment of patient with multiple enterocutaneous fistulas after bariatric surgery, including a comprehensive preoperative preparation for 3 months (sepsis control, nutritional support and wound care) and reconstructive surgery (laparotomy, distal gastrectomy, resection of the small bowel with fistulas, Roux-gastrojejunostomy, transversostomy).

[Surgical treatment of enterocutaneous fistulas in patients with ventral incisional hernia].

Objective: To determine the optimal surgical treatment in patients with enterocutaneous fistulas combined with ventral incisional hernia.

Material And Methods: There were 24 patients with enterocutaneous fistulas combined with ventral incisional hernia. Enterocutaneous fistula was noted in 19 cases, enteroatmospheric fistula - in 5 patients.

[Pancreatic proinsulinoma].

Objective: To report own experience in the treatment of patients with proinsulinoma.

Material And Methods: There were 10 patients with increased proinsulin production and normal insulin level since 2017. Most of them were young women.

[Postpancreatectomy hemorrhage].

Surgical treatment of pancreatic diseases is always associated with a large number of complications. Postoperative hemorrhage is a specific complication of pancreatic surgery requiring a clear classification and surgical strategy. According to literature data, postoperative hemorrhage occurs in 3-30% of cases.

Successful surgical treatment of a patient with primary insulinoma of the liver.

Insulinoma is the most frequent functional neuroendocrine tumor of the pancreas, which causes organic hyperinsulinism with severe hypoglycemia. There are no cases of primary insulinoma of the liver described. A 63-year-old female was admitted to our center presenting symptoms of severe hypoglycemia due to confirmed endogenic hyperinsulinism.