Modern Aspects of Minimizing Postoperative Complication Pankreatoduodenal Resections for Obstructive Diseases Pancreaticoduodenal Zone

Abstract

Summary. The aim of the study. Pancreatoduodenal resection (PDR) is one of the most traumatic cases, and in the post-operative period, patients can develop complications, which often lead to poor results of surgical excision. The rate of postoperative mortality in patients who have undergone PDR is 5 to 10 %, and postoperative complication is blamed on 20-60 %.
 The method of this work led to the development of complications, clinical indications in the rehabilitation of ailments in the early post-operative period, as a result of which various surgical technologies were introduced to the PDR.
 Materials and methods. In 151 ailing viconan pancreaticoduodenal resections (PDR) due to cancer of the glans subscapularis 83 (58.8 %), cancer of the periampullary zone 40 (28.4 %) and chronic pseudotumorous pancreatitis 18 (12.8 %) patients.
 Results and discussion. The technique of molding pancreatojejunostomy at the stage of PDR has been developed to ensure a decrease in the total number of complications in patients with terminal lateral anastomosis according to Whipple, as well as terminological equipment according to Shalimov-Kopchak. The number of ailments with complications is decreasing: termino-lateral according to Whipple pancreatojejunoanastomosis (59.4 %), termino-terminal according to Shalimov-Kopchak (58.3 %), according to the method of our clinic (30.8 %), pancreatogastroanastomosis (24.3 % ). with isolation of sutured ducts 22.6 ( %).
 Conclusions. We have developed methods for forming pancreatico-juvenile anastomosis at the end of the last stage of PDR to ensure a decrease in the total number of complications in patients with traditional thermolateral overlays after Whipple, as well as termoterminal anastomosis after Shalimovim-Kopchak, up to 52.6 % in 22,6 %.