2018 were included in the study. We retrospectively reviewed the patient's preoperative, operative and postoperative data. Primary outcome was major morbidity and 90-day mortality, and secondary outcome was overall survival. Results: Major morbidity occurred in 9 patients (18.8%). 13 patients (27.1%) had pancreatic fistula grade B or C according to ISGPS guideline. There was 1 case (2.1%) of 90-day mortality after operation. Kaplan-Meier estimated median overall survival was 25.0 months. Conclusions: DP-CAR is a good treatment option for cure in pancreatic body and tail cancer with celiac axis involvement without significant morbidity and mortality.

jaundice and hepatic failure, increasing complications and recovery cost. Methods: 28 (6.1%)of 462 patients with LHD had cyst's burst into biliary tree in age 22-62. The standard exams consisted from general examination, blood analysis, blood biochemical tests supplemented with enzyme linked immune assay (ELISA), as well as retrograde pancreatocholangiography (RPCG). In 20 (72%) cases after EPST it has been done an extraction of chitin coat and elimination of mechanical block with biliary tract lavage. Further all these patients were performed a postponed opened operation. In 8 (28%) cases the attempts of chitin coat removal were not successful, patients were urgently operated. Results: The sensitiveness of ELISA method was about 96.3%. In 20 of 28 patients (71.4%) we have reached total elimination of mechanical obstacle by EPST with decreasing of bilirubine at day 6-7. 8 patients (29.6%) with unsuccessful attempts, have been operated afterwards, and bilirubin level got to normal at postoperative day 11-12. Conclusion: Thus, the complex approach including RPCG is not only high-specific diagnostic method, but also is the treatment one, and allows to eliminate mechanic jaundice, to adequately clean bile ducts, and diminishing the risk of complications.

Вступление. Приведен опыт лечения желчеистечения вследствие «малых» повреждений желчных протоков (ЖП) при лапароскопической холецистэктомии (ЛХЭ). Показаны преимущества миниинвазивных технологий по сравнению с открытыми хирургическими вмешательствами. Материалы и методы. В 2001 - 2015 гг. в клинике лечили 45 пациентов по поводу желчеистечения вследствие «малых» повреждений ЖП. В основной группе применяли миниинвазивные технологии, в группе сравнения - открытые хирургические методики. Результаты. В основной группе в два раза чаще применяли миниинвазивные технологии по сравнению с группой сравнения. Вывод. Миниинвазивные методики, в частности, релапароскопия, ретроградные транспапиллярные вмешательства, чрескожное дренирование, позволяют достичь лучших результатов, они должны быть приоритетными у больных при возникновении желчеистечения после ЛХЭ. Ключевые слова: лапароскопическая холецистэктомия; «малые» повреждения желчных протоков; миниинвазивные технологии.

34% male vs 32%). The 2 techniques allow 100% of CBD clearance. Intraoperative ERCP had an ideal clearance of CBD of 62% and 10% in the other group (p <0.001). The frequency of the biliary drainage was 17% after intraoperative ERCP and 28% after surgical approach (p = 0.014). The frequency of abdominal drainage was 38% after intraoperative ERCP and 86% after surgical approach (p <0.001). Morbidity and mortality were identical. Hospital stay was 6 days [1e29] and 8 days [1-41] after ERCP and surgical approach, respectively (p = 0.03). Conclusions: The rate CBD of clearance is equivalent for both techniques and the choice between the 2 techniques depends mainly on the surgical team usual practice. However, intraoperative ERCP with laparoscopic cholecystectomy may be preferred due to the low rate of abdominal and biliary drainage.

, 34% male vs 32%). The 2 techniques allow 100% of CBD clearance. Intraoperative ERCP had an ideal clearance of CBD of 62% and 10% in the other group (p <0.001). The frequency of the biliary drainage was 17% after intraoperative ERCP and 28% after surgical approach (p = 0.014). The frequency of abdominal drainage was 38% after intraoperative ERCP and 86% after surgical approach (p <0.001). Morbidity and mortality were identical. Hospital stay was 6 days [1e29] and 8 days [1-41] after ERCP and surgical approach, respectively (p = 0.03). Conclusions: The rate CBD of clearance is equivalent for both techniques and the choice between the 2 techniques depends mainly on the surgical team usual practice. However, intraoperative ERCP with laparoscopic cholecystectomy may be preferred due to the low rate of abdominal and biliary drainage.