Ivan Stepanovich Kolesnikov (1901-1985) - Soviet surgeon, Doctor of Medical Sciences, Professor, Academician of the Academy of Medical Sciences of the USSR, Major General of the Medical Service, Honored Scientist of the RSFSR (1964); Hero of Socialist Labor (1976). Laureate of the Lenin Prize and the USSR State Prize. November 4, 1968 at the Department of Hospital Surgery Professor IS Kolesnikov, together with Academician of the Academy of Medical Sciences of the USSR Colonel-General of Medical Service A. A. Vishnevsky performed the first in our country heart transplantation (1 figs, bibliography: 15 refs).

Treatment and prevention of complications of portal hypertension today is a complex and unsolved problem of hepatosurgery. Mortality from esophageal-gastric bleeding (ESH) of portal genesis ranges from 22 to 100%. The aim of the study is to improve the results of the treatment and prevention of digestive haemorrhage in portal hypertension by optimize using of miniinvasive interventions. A retrospective analysis of the treatment results of 128 patients with cirrhosis of the liver, in which the predominant complication of portal hypertension resulted in bleeding from varicose veins of the esophagus and the stomach, and a high risk of its occurrence or recidivism have been carried out. Gastric laparoscopic devascularization with endoscopic ligation reduces the lethality from esophageal-gastric bleeding, compared to only ligation, for six months after the operation by 21.8% (2 = 2.61; p = 0.106), 25.5% within a year (2 = 2.75; p = 0.091), for two years after the 25.4% operation (2 = 1.47; p = 0.225), for three years 25.5% (2 = 0.43; p = 0.051). There is a statistically reliable lack of differences in the groups of patients after the traditional and endovideoxyric operations of the portocal bypass in terms of the reduction of the degree of VDEV (84.3 and 86.7%), which indicates the equivalent effect of the performed operations. A comparative study of selective portocaval anastomoses and TIPS found no reliable difference in the frequency of recurrent bleeding. Post-shunt encephalopathy, thrombosis, and stenosis of the shunt were more common in the transjugular intrahepatic portosistame shunt (p 0.001), and survival in the group of surgical anastomosis was superior to that of TIPS. The above data indicate that the use of endoscopic, endovascular, endovision and endovision surgery, extracorporeal miniinvasive techniques is an integral part of the complex surgical treatment of patients with portal hypertension. Miniinvasive surgical treatments are required depending on the current clinical situation and the degree of liver-cell failure. Flexible and selective tactics make it possible to improve the results of treatment of patients with cirrhosis of the liver, complicated by portal hypertension (6 figs, bibliography: 14 refs).

Topographic and anatomical variants of vascular plastics in extended gastropancreatoduodenal resection are substantiated. The anatomical study was performed on 30 organ complexes and 5 not embalmed human corpses. Significant variability of the roots and tributaries of the v. portae and their location near the pancreas was revealed. The extended contact of the mesenteric-portal segment with the head of the pancreas promotes the involvement of the veins of the portal system in the tumor process. The magistral type of the structure of the superior mesenteric vein was revealed in 19 cases, the distributed type in 11, which determines the conditions for vascular reconstruction. In the experiment the possibility of creation the formation of the direct mesenteric-portal anastomosis after duodenectomy was established in case of shifting the mobilized root of the mesentery of the small intestine in the direction of the liver gate. If splenic vein resection is necessary, adequate blood outflow from the stomach, spleen, and pancreatic stump can be provided by forming a distal splenic-renal anastomosis or, with a sufficient length of the splenic vein, a splenic-portal anastomosis. Based on computed tomography angiographs and intraoperative data 29 patients underwent extended gastropancreatoduodenal resection followed by vascular reconstruction. Tumor invasion of the trunk of the portal vein on computed tomography angiograms was represented by offset and the contact of the tumor with portal vein for over 10 mm (in 7 cases), the displacement and deformation of the portal vein tumor (in 5 cases), tumor infiltration of more than 50% of the circumference of the portal vein (in 3 cases). Extended contact with the tumor was identified in 9 cases, confluence stenosis of the portal vein in 5 cases. The tumor invasion into the portal vein, and the vascular system was restored by the formation of a port-portal anastomosis in 15 cases. Moreover at the reconstruction of mesenteric-portal segment we formed mesenteric-portal anastomosis in 10 cases. Also in 2 cases mesenteric-portal anastomosis in the confluence area of the iliac colon and jejunum tributaries was formed, in 1 case we formed anastomosis between the ileum-colon vein and the portal vein (with 1:2 diameter difference without patency disorders). In one single case we connected iliac colon vein wall with jejunum vein wall and formed anastomosis between them and portal vein. Distal splenorenal anastomosis was formed in 10 patients from this group. Spleno-portal anastomosis was formed in 3 patients above the junction of the portal and superior mesenteric veins.