a new method for surgiCal treatment of Cysts loCated in the head of the panCreas a b s t r a c t-Over the past two decades, the number of patients with cystic formations of the pancreas has increased significantly. Especially the most productive part of the population aged 35-50 years suffers from this disease. The question of the choice of optimal and rational treatment policy is still an actual problem of modern surgery. The problem of choosing the most radical and at the same time the organ-preserving technique, helping to improve the immediate and long-term results, the quality of life and social and labor rehabilitation, has not lost its relevance, and the studies carried out in this area are currently important. K E y w o r d s-cyst of the pancreas, internal drainage, pancreatocystogastrostomy. i n t r o d u C t i o n Among experts there is no consensus in matters of surgical tactics for pancreatic cysts [2]. The range of surgical interventions performed for pancreatic cysts is quite wide: external drainage of cysts, enucleation of a cyst, various in volume resections of the pancreas together with a cyst (radical operations), the formation of internal fistulae between the cyst wall and various sections of the gastrointestinal tract. Internal drainage of pancreatic cysts is most prevalent. The frequency of its use reaches from 30 to 60% [4, 5, 6]. Indications for internal drainage of pancreatic cysts are [2, 6, 7]: 1. The presence of single-chamber pancreatic cysts formed with the capsule communicating with the ductal system of the pancreas 2. Cysts of retention 3. The location of pseudocysts in the head of the pancreas 4. Cystic expansion of the main pancreatic duct. Performing internal drainage is especially advisable when pancreatic cysts are located in the head of the pancreas, since [4]:

Астраханский государственный медицинский университет, Российская Федерация meThoD of pancreaTocYsTogasTrosTomY in The preVenTion of posToperaTiVe complicaTions WiTh pancreaTic heaD cYsTs odishelashvili g. D., ilyasov r. K., pakhnov D. V., Kurtusunov B. T.astrakhan state medical university, russian federation В эксперименте на 18 беспородных собаках разработан новый способ панкреатоцистогастростомии, который заключается в формировании соустья между полостью кисты и задней стенкой пилоро-антрального отдела с последующим восстановлением непрерывности желудочно-кишечного тракта. В послеоперационном периоде, с 1 дня до 6 месяцев, изучены экскреторная и инкреторная функции поджелудочной железы, уровень кислотности в пилороантральном отделе желудка.

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During the period 2011–2021, 45 patients with pancreatic cysts were treated at the AlexanderMariinsky Regional Clinical Hospital in Astrakhan. All patients were divided into 2 groups. 20 patients of the first group (45%) underwent external drainage of cysts, 7 out of them underwent obliteration of residual cavities by the method developed by us. To do this, the drug Povidone – Iodine 10% was used. The second group included 25 (55%) patients with internal drainage of cysts: in 5 patients (11%) pancreacystogastrostomy was performed; in 9 patients (20%) — pancreatocystoejunostomy; in 5 patients (11%) — pancreatic drainage; in 5 (11%) — laparoscopic cystectomy; and open echinococcectomy was performed in 1 patient (2%). Clinical, laboratory, instrumental and statistical research methods were carried out. A comparative evaluation of two methods of drainage operations for pancreatic cysts showed the advantage of internal drainage over external. 7 (16%) patients had a variety of complications. The recurrence of cysts was 4 (9%) cases. All the patients recovered. There were no cases of lethality.