[Stomach and spleen preserving total pancreatectomy]. / Total'naya duodenopankreatektomiya s sokhraneniem zheludka, selezenki, zheludochnykh i selezenochnykh sosudov.

INTRODUCTION: Pancreatic surgery expands the indications and the use of total pancreatectomy. Considering a rather high rate of postoperative complications, the search for the ways to improve its outcomes is extremely relevant. The purpose of this study is justification and implementation of organ-preserving variants of total pancreatectomy. MATERIAL AND METHODS: Retrospective analysis of treatment results after classic and modified total pancreatectomy in the surgical clinic of Botkin Hospital was performed from September 2010 to March 2021. During the development and implementation of pylorus-preserving total pancreatectomy with preservation of the stomach, spleen, gastric and splenic vessels, we thoroughly analyzed aspects of exocrine/endocrine disorders and changes of the immune status after performing the modified technique. RESULTS: We performed 37 total pancreatectomies, including 12 pylorus-preserving total pancreatectomies with preservation of the stomach, spleen, gastric, and splenic vessels. General and specific postoperative complication rate in patients after the modified operation was significantly lower compared to the results of classic total pancreatectomy with gastric resection and splenectomy. CONCLUSION: Modified total pancreatectomy is a method of choice for pancreatic tumors of low malignant potential.

[Spleen-preserving total pancreatectomy for low-grade tumors]. / Pilorosokhranyayushchaya pankreatektomiya s sokhraneniem selezenki pri opukholyakh s nizkim potentsialom zlokachestvennosti.

OBJECTIVE: To justify organ-preserving variants of total pancreatectomy. MATERIAL AND METHODS: We retrospectively analyzed the results of classic and modified total pancreatectomy between September 2010 and March 2021. Implementing pylorus-sparing total pancreatectomy with preservation of stomach, spleen, gastric and splenic vessels, we thoroughly analyzed exocrine/endocrine disorders after total pancreatectomy and changes in immune status after splenectomy. Serum C-reactive protein and ferritin were assessed in 1, 3, 5, 7, 14 and 30 days after surgery in both groups. We also estimated daily glycemic profile after total pancreatectomy in classical and organ-preserving modifications. RESULTS: We performed 37 total pancreatectomies including 12 pylorus-preserving total pancreatectomies with preservation of stomach, spleen, gastric and splenic vessels. General and specific postoperative complication rate was significantly lower after modified surgery compared to classic total pancreatectomy with gastric resection and splenectomy. CONCLUSION: Modified total pancreatectomy is preferable for low-grade pancreatic tumors.