[Distal pancreatic resection with common hepatic artery en block].

One of the most frequent cause of inoperability of the pancreatic tumor is the vascular invasion of truncus coeliacus and common hepatic artery. In 1953 Appleby suggested the en block truncus coeliacus and distal pancreatic resection together with gastrectomy for the treatment of the locally disseminated gastric cancer. The method was later modified for the resection of pancreatic body and tail tumors (without gastrectomy) and in 1991 was named "the modified Appleby operation". The study aimed to analyze the first Russian experience of the treatment of 2 patients with the use of the method.

[Use of implanted intravascular catheters with subcutaneous "ports" in the treatment of surgical diseases].

Special implanted vascular catheters with subcutaneous "ports" were used in 120 patients for infusions into arteries, veins and abdominal cavity. The results demonstrate high efficacy of this method in the treatment of surgical and cancer patients.

[Laparoscopy and puncture biopsy in diagnosis of focal lesions of the liver]. / Laparoskopicheskoe issledovanie i punktsionnaia biopsiia v diagnostike ochagovykh porazhenii pecheni.

Based on the results of examination of 208 patients with different tumors of the liver it is concluded that in the majority of cases it is possible to avoid puncture biopsy of the liver and laparoscopy for diagnosis of focal lesion of the liver (FLL) before surgery because these invasive procedures don't improve efficacy of diagnosis. On the contrary it may lead to complications including implantation metastases (3.33%). Correct appliance of modern diagnostic algorithms permits to increase efficacy of FLL diagnosis to 82.27% without invasive procedures.

[Cytoreductive surgery of liver metastasis from colorectal cancer: principles of intra-arterial regional chemotherapy]. / Tsitoreduktivnaia khirurgiia metastazov kolorektal'nogo raka v pecheni: printsipy i intra-arterial'naia regionarnaia khimioterapiia.

A significant number of patients with colorectal cancer have metastases (MTS) to the liver. Cytoreductive surgery (CRS) and new antitumor drugs provide promising results. The aim of the study was to evaluate clinical results of CRS in combination with modern antitumor drug irinotekan (kampto). Forty-seven patients suffering from colorectal cancer with MTS to the liver were treated. Primary focus was resected. All the patients were divided into 4 groups depending on combination of surgical treatment and chemotherapy: with liver resection and complete removal (or devitalization) of metastatic lesions in combination with postoperative intravenous (group 1) or intraarterial regional (group 2) injection of Irinotekan and without resection of the liver with implantation of a catheter to the hepatic artery with postoperative intraarterial (group 3) or systemic intravenous (group 4) therapy with Irinotekan. Mean dose of kampto was 350 mg per 1 m2 of body surface. It was demonstrated that intraarterial infusion was highly effective. The follow-up in group 1 was 9.5 +/- 3.75 months, in group 2--11.3 +/- 4.2, in group 3--6.5 +/- 5.3, in group 4--4.6 +/- 2.3 months. It is concluded that cytoreduction of the the liver with intraarterial intrahepatic regional chemotherapy is an effective method of treatment of patients with metastatic colorectal cancer of the liver.

[Dynamic omento-pancreatostomy in the treatment of acute destructive pancreatitis]. / Dinamicheskaia omentopankreatostomiia v lechenii ostrogo destruktivnogo pankreatita.

The authors suggest a new method for treating acute pancreatitis, which is based on the principles of an "opened abdomen" but combines practically all its advantages. The operation is called "dynamic omentopancreatostomy". This method was used in 1986-87 for the treatment of 13 patients, 7 of them had destructive pancreatitis with total and subtotal necrosis of the pancreas. Severe specific complications characteristic of acute pancreatitis occurred in all of the patients. Three patients died in the post-operative period. Most of the developing complications were easily arrested by means of this new operative method. It is concluded that seriously ill patients with omentopancreonecrosis may be treated successfully by the operation of "dynamic omentopancreatostomy".