[Show abstract][Hide abstract]ABSTRACT: The results of 302 operations on the pancreas were analyzed: of them 107 were pancreatoduodenal resections; 67 were distal resections of the pancreas; 74 were various resections of the head of the pancreas and middle resections and 54 other operations. The postoperative pancreatitis was registered in 178 patients. The preventive use of the octreotide intraoperatively and in early postoperative period showed no influence on the frequency and severity of the postoperative pancreatitis. The ultrasound was the optimal screening diagnostig method, whereas the computed tomography was the best in pancreonecrosis diagnostics and the volume of the pancreatic tissue damaged. Of 178 patients with the postoperative pancreatitis 17 died, the lethality rate was 9.5%.
[Show abstract][Hide abstract]ABSTRACT: The indications to Frey operation are severe pain syndrome and pancreatic hypertension, caused by concrements and strictures of the main pancreatic duct and/or postnecrotic pancreatic cysts. The pancreaticojejunoanastomosis is performed on the isolated by Roux intestinal loop. The average operating time was 4.62±1.39 hours. 28,3% of the operated patients developed various postoperative complications. 2 (6.7%) patients had the anastomosis insufficiency; the 2 patients had intraanastomotic bleeding and 1 patient had the arrosive bleeding caused by pancreonecrosis. 2 patients had external pancreatic fistulae. 1 patient died. The average hospital stay after the operation was 12±4 days.
[Show abstract][Hide abstract]ABSTRACT: Treatment results of 5 patients with unformed intestinal fistulae are represented. High unformed intestinal fistulae are acknowledged to be completely unsuitable for conservative treatment and should be operated on. Complex treatment should include complete parenteral feeding, adequate fecal diversion with the use of aspirational drainage. Surgical treatment must be y the increase of fistula discharge or absence of fistula formation. Low intestinal fistulae should better be surgically dissected after their organization, otherwise urgent surgery is to be performed by complications development, such as purulent leakage into the abdominal cavity or severe wound infection.
[Show abstract][Hide abstract]ABSTRACT: The authors have analyzed results of treatment of 26 patients with chronic pancreatitis complicated by pseudoaneurysms. Hospitalization and treatment of such patients should be performed in specialized hospitals which can fulfill special examination in detail and carry out roentgen-endovascular operations. Intraintestinal bleeding is an absolute indication for emergent surgery for performing hemostasis. Conservative treatment is indicated for intestinal bleedings and after arrest of bleeding the patients should be transported to specialized institutions. Two types of the appearance of pseudoaneurysms were established depending on the pathological mechanism: when there was a relationship of the pseudocyst with the main pancreatic duct (I type) and when there was not (II type). For the I type roentgen-endovascular treatment (RET) followed by operation is indicated, for the II type RET is thought to be enough.