[Surgical correction of complicated forms of chronic pancreatitis].

In the clinic in 2009 - 2011 yrs 43 patients were operated for complicated forms of chronic pancreatitis (CHP). Basing on the CT and endoscopic retrograde pancreatocholangiography data, the pancreatic pathology variants, significant for the operative method choice, were delineated. The intraoperative biopsy material estimation have shown, that the main sign of CHP in all the cases was prominent pancreatic fibrosis, and in the degree III fibrose the fibrous tissue have constituted 68.2-76.4% of pancreatic tissue, exocrine--16.2-24.8%, in the degree IV fibrose--79.5-95.5 and 2.3-10.8% accordingly. The indications for organ preserving resectional, resection-draining interventions and isolated, draining pancreatic duct system operations, were formulated. The rate of combined resection-draining interventions with duodenal preserving have constituted 30.2%. Total postoperative stationary mortality was 2.3%. The stationary postoperative patients stay was (9.1 +/- 0.8) days.

[The evaluation of pathogenic factors in duodenal ulcers]. / Otsenka faktorov patogeneza iazvennoi bolezni dvenadtsatiperstnoi kishki.

There were examined 90 patients with severe course of duodenal ulcer disease. In 83% of patients the atropinedependent reaction of acid production was noted, giving evidence the dominant influence of neural regulation on gastric secretion, in 17%--atropineresistant reaction, giving evidence the hormonal mechanism of regulation.

[The involvement of specific immune reactions in the regulation of acid-forming function of the stomach in duodenal ulcers]. / Uchastie spetsificheskikh immunnykh reaktsii v reguliatsii kislotoobrazuiushchei funktsii zheludka pri iazvennoi bolezni dvenadtsatiperstnoi kishki.

Fifty patients with duodenal ulcer disease were examined. In 17 patients (1 group) the constantly recurrent course of the disease was noted, in 33 patients (2 group) the complications (hemorrhage, perforation, stenosing) have occurred in anamnesis. In patients of the first group the acid production rising was concomitant with specific somatostatin-dependent cell reactions domination, in the second one--pentagastrin-dependent.

[The choice of the method for surgical intervention in duodenal peptic ulcer depending on the state of the regulatory links in the gastric acid-forming function]. / Vybor metoda operativnogo vmeshatel'stva pri iazvennoi bolezni dvenadtsatiperstnoi kishki v zavisismosti ot sostoianiia reguliatornykh zven'ev kislotoobrazuiushchei funktsii zheludka.

Gastric secretion and the state of D-somatostatin- and G-gastrin-producing cells of gastric antrum were studied in 41 patient with continuously recurrent course and complications of the disease to choose the operative treatment method for duodenal ulcer disease. Atropine-dependent (AD) gastric secretion was revealed in 90.3% of patients, and atropine-resistant (AR)-9.7%.G-cells hyperplasia was revealed in 19.5% of patients. Three clinically important variants of D- and G-cells ratio were chosen: hyperplasia it absent, G-cell hyperplasia is present with the balanced ratio to D-cells, G-cell hyperplasia is present with aggressive ratio to D-cells. Truncal vagotomy with antrumectomy was conducted in patients with the third ratio variant, various kinds of vagotomy were done in patients with the first and second variants against the AD gastric secretion.