[The splanchnic blood flow indices in the patients, suffering external pancreatic fistula, and their dynamics under the influence of sandostatin and somatulin according to the ultrasonographic duplex scanning data].

Hemodynamical effects of the somatostatin analogues were studied in the patients with external pancreatic fistula. There were examined 29 patients, using ultrasonographic duplex scanning, for investigation of the blood flow indices in a. mesenterica superior, truncus coeliacus and its branches, v. lienalis, v. portae and pancreatic intraorgan arteries. Initial indices of splanchnic blood flow were compared with such while administration of octreotide. The main splanchnic blood flow indices in patients, suffering external pancreatic fistula, did not differ from that in controls, the lowering of the pulsation and resistance indices was noted as well as enhancement of the vessels quantity in pancreatic surgical margin. Under the influence of somatostatin the quantity of visualized vessels had reduced, the pulsation and resistance indices increased, the blood flow velocity along a. mesenterica superior, a. lienalis and pancreatic intraorgan arteries lowered, causing reduction of the blood flow linear and volumetric velocity along v. mesenterica superior and vv. intrapancreatici. Inhibitory action of the preparation on splanchnic blood flow was maximal in terms from 6 till 24 h after its infusion and had lowered step by step during all the follow-up period.

[Surgical treatment of pancreatic fistula]. / Khirurgicheskoe lechenie pankreaticheskogo svishcha.

Results of treatment of 149 patients with external pancreatic fistula for 1990-2000 yrs period were analyzed. Roentgencontrast fistulography, ultrasonic investigation, endoscopic retrograde pancreatography are the main diagnostic methods of the disease. Conservative therapy was conducted in 57 patients, sandostatin was administered in 0.1 ml dosage subcutaneously every 8 h during 5-8 days. It turned to be effective in 42 (73.7%) of patients. Fistulopancreatojejunostomy, fistulojejunostomy, pancreatic resection of its part, carrying fistula, were the main methods of operative treatment. Postoperative complications occurred in 7 (7.6%) of patients. All the patients are alive.

[Drainage or resecting surgery in chronic pancreatitis?]. / Dreniruiushchie ili rezetsiruiushchie operatsii pri khronicheskom pankreatite?

An analysis was done of treatment of 333 patients with complicated forms of chronic pancreatitis (ChP) who had undergone interventions in the pancreas over the period 1996-2001. The draining operations having been performed in the above patients came up to 91.3 percent of the total number of operations while resecting type surgery was 8.7 percent. Efficiency was analyzed of making use of draining operations in different forms of ChP. The authors suggest a number of novel draining operations aimed at preservation of the function of the pancreas and organs of the pancreatoduodenal zone, which fact is found out to qualitatively change results of surgical treatment in the patients under consideration. Resecting operations are performed more frequently in fibrous changes in the pancreas, with the adjacent organs being involved in the pathological process. Indications are determined for performing resecting operations in ChP.