Tkachuk O. Diagnosis and surgical treatment of tumors of the left anatomical segment of the pancreas

In the dissertation peculiarities of clinical course of tumors of the left anatomic segment of the pancreas were estimated, diagnostic accuracy of different tools was analyzed. Based on the determination of the efficacy of diagnostic tools, the effective algorithm of perioperative investigation that includes contemporary methods of clinical, laboratory, instrumental investigations, intraoperative revision and morphological diagnostics was formulated, worked out and evaluated. Implementation of the contemporary diagnostic algorithm resulted in the increase of the efficacy of the preoperative diagnosis and decrease of the explorative laparotomy. Operations from laparoscopic access, RAMPS, extended distal resection of pancreas with simultaneous vascular and/or adjacent organ resection, local pancreatic resection (including those from laparoscopic access) were worked out, the indications were clarified, procedures were implemented; their results were evaluated and their role in the treatment algorithm was established. Individualized tactics of treatment that takes into account type of the disease was worked out. Risk factors of early postoperative complications and mortality have been established and options of their prophylaxis have been proposed. Implementation of the modified extended resection with simultaneous vascular and adjacent organs resection made it possible to increase the number of radical resection on more than 23% without an increase of postoperative morbidity and mortality. Implementation of the diagnostic and treatment algorithm and contemporary techniques made it possible to decrease early postoperative morbidity and mortality