PROBLEMS OF SURGERY IN CHRONIC DISEASES O F THE PANCREAS

The work analyses the results of 999 operations on the pancreas conduc ted in 861 patients with chronic oncological and nonneoplastic disease s of the gland. Pancreatoduodenal resection (PDR) was performed in 171 patients (for tumors of the pancreaticoduodenal zone in 151 and for c hronic pancreatitis of the head of the glandin 20) in 13 of them a mod ified operation with preservation of the stomach and pylorus was carri ed out. The late-term results were satisfactory in both groups of pati ents, the survival of oncological patients was much higher after radic al operations then after palliative surgery. Total duodenopancreatecto my has no advantages over PDR and should be undertaken only when there are strict indications. In chronic pancreatitis, complicated also, pr eference was given to organ-preserving interventions, primarily to dra ining operations, which preserve more fully pancreatic exocrine and en docrine functions: longitudinal pancreatoejunostomy was conducted in 1 06 patients, internal drainage of pancreatic cysts in 184, and occlusi on of external pancreatic cysts in 70 patients. It is advisable that t he most complicated, particularly repeated and reconstructive, operati ons on the pancreas are carried out at specialized centers in which th e problem of surgical diseases of the pancreas is studied more closely .