Bobro V. Surgical treatment of pancreatic pseudocysts and their complications.

The thesis is devoted to the problem of improving the results of surgical treatment of pancreatic pseudocysts and their complications. Retro- and prospective analysis of surgical treatment of 103 patiens with pancreatic pseudocysts was conducted. The correlations between calcium and thyroid homeostasis and the risk of postoperative complications in varying degrees of maturity of pancreatic pseudocysts were investigated for the first time. For the first time we scientifically proved the value syndrome "low triiodothyronine"and the changes of the relative content of ionized calcium for postoperative period in patients with pancreatic pseudocyst. The predictors of perioperative morbidity period were identified, their discriminatory features and prognostic sagnificance in different types of surgical tactics were studied. The model of calculation of the risk of postoperative complications for the stratification of patients in the prehospital stage was offered. For the first time the sensibility of using oxytocin for the acceleration of the process of forming of a wall of an immature pseudocyst, the efficiency of using of the method of accelerated forming of a wall of an immature pseudocyst for the optimization of the postoperative period were scientifically justified and clinically proved. The developed diagnostic and treatment algorithm, with taking into account the degree of stratification level, permited to determine the optimal tactics of the treatment which allowed to avoid lethal results, brought to conducted to decreasing of the risk of relapses for 22, 8 % (p< 0,05), suppuration from 23,6 % to 8, 3% (p< 0,05), permited to decrease the total amount of postoperative complications for 39, 1 % (p < 0,05),to avoid postoperative fistulae, to limit staying of patients in an inpatient department for 4,6± 1,6 days (p< 0,05).