EVALUATION OF RESULTS OF ERAS PROGRAM AFTER PANCREATODUODENECTOMY DEPENDING ON THE TYPE OF GASTROINTESTINAL RECONSTRUCTION.

Objective: The aim: To assess the effect of gastrojejunostomy with Braun anastomosis during PD for prevention of DGE in ERAS protocol patients.

Patients And Methods: Materials and methods: A total of 92 patients from 28 to 75 years were included in this study, who underwent PD with ERAS program. Patients were divided into 2 groups, depending on type of reconstruction - PD with Child reconstruction and PD with gastrojejunostomy with Braun anastomosis.

PERIOPERATIVE MULTIMODAL PROGRAM OF ENHANCED RECOVERY FOLLOWING PANCREATICODUODENECTOMY.

Mortality after pancreaticoduodenectomy (PD) decreased from 25% to 1-3% in the last decade. However, the number of early postoperative complications varies from 29.5% to 70%.

[Peculiarities of diagnosis and surgical treatment of nonfunctioning neuroendocrine pancreatic tumors].

The results of diagnosis and treatment in 2004-2012 yrs period of 79 patients, suffering nonfunctioning neuroendocrine pancreatic tumors (NNPT), were analyzed. Effective diagnostic tactic while preoperative predilection on the NNPT presence for the diagnosis verification was proposed, permitting to determine the optimal method of surgical treatment, to introduce organpreserving and laparoscopic interventions, to widen indications for surgery for the NNPT extended forms.

[Prophylaxis of injuries of biliary ducts in laparoscopic cholecystectomy: clinical recommendations of Ukrainian association of specialists for miniinvasive, endoscopic and laser technologies].

Wide introduction of laparoscopic cholecystectomy (LCHE) caused during last 20 years a significant enhancement of rate of the biliary ducts injuries (BDI). Taking into account the experience gained in performing of more than 40,000 operations of LCHE in a leading clinics, including such in a technically complex situations, as well as experience of more than 500 operations performance for BDI, clinical recommendations, based on principles of a substantiality medicine were elaborated. More than 100 sources of foreign and domestic literature were analyzed, summarizing the results of more than 150,000 operations of LCHE, special attention was drawn to the sources I (meta-analysis and prospective randomized investigations) and II (systematic reviews, thoroughly planned prospective comparative investigations) levels of substantiality.

[Laparoscopic therapy of organic hyperinsulinism].

The results of laparoscopic treatment were analyzed in 9 patients, suffering pancreatic insulinoma, in the clinic in 2008-2012 yrs. Tumoral enucleation was performed in 6 patients, distal pancreatic resection--in 3. In 1 (11.

[Combined injuries of bile ducts and hepatic artery branches in cholecystectomy].

Results of treatment of 25 patients with combined injuries of bile ducts and the common hepatic artery in performing cholecystectomy were studied. In 19 (73.1%) patients the injuries were noted during open and in 7 (26.

[Peculiarities of postoperative complications in laparoscopic surgery].

Retrospective analysis of postoperative complications, occurred in patients, to whom laparoscopic interventions were performed in the Department of Laparoscopic Surgery and Cholelithiasis, was conducted. The rate of inflammatory and thromboembolic complications have constituted 2.2 and 0.

[Combined injury of biliary ducts and vessels during cholecystectomy: peculiarities of clinical course and surgical tactics].

The results of treatment of 56 patients, in whom in 1984-2010 yrs, while performing cholecystectomy, a biliary duct injury have occurred, were analyzed, including 26 (main group)--with combined injury of biliary ducts and brunches of common hepatic artery, 30 (control group)--with isolated complete biliary ducts. High hepaticojejunostomy have constituted the main method of operation in a control group. In the main group in 2 patients there were attempts made to restore the arterial blood flow with subsequent performance of reconstructive intervention on biliary ducts.

[Mini-invasive interventions for cystic formations of the spleen].

The data of complex clinical examination and surgical treatment of 89 patients, having splenic cysts (SC), are analyzed. Indications and contraindications for miniinvasive methods of treatment (laparoscopic and puncture-draining procedures under ultrasonographic control) application are substantiated, taking into account their size, localization, pathogenesis and presence of SC complications. Diagnostic efficacy of abdominal ultrasonography, computer tomography for SC was estimated, the significance of these methods, while choosing a rational tactics of treatment, was determined.

[Significance of transplantation technologies in prophylaxis of pancreatic fistula formation after pancreatoduodenal resection].

The experience of pancreaticoduodenal resection performance in 110 patients in 1996-2008 yrs was presented. The comparative analysis of the operations results was conducted between 49 patients, in whom standard methods were applied (I group), and 61 patients, who were operated on, using transplantation technologies (II group). Transplantation technologies application have permitted to reduce essentially the postoperative pancreatitis occurrence--from 30.

[Rational technique of pancreatoduodenal resection and transplantation technology use as the basis of favourable outcome].

Outcomes of pancreatoduodenectomies performed during the period from 1996 to 2008 in 110 patients with malignant diseases of pancreaticoduodenal zone and complicated forms of chronic pancreatitis with predominant changes of the pancreatic head were presented. Age of patients ranged from 17 to 73 years, on average (52.0 +/- 9.

[Classification of iatrogenic damages of biliary ducts in cholecystectomy].

While introduction of laparoscopic technologies into clinical practice the extrahepatic bile--efferent ways damages during cholecystectomy performance had increased from 0.1-0.2 to 0.