Veligotsky O. Tactics of surgical treatment of obstructive diseases of pancreatoduodenal zone and their complications.

The results of surgical treatment 304 patients with obstructive diseases of pancreatoduodenal zone incorporated in uniform group of complex pathological processes, with obturation of terminal departments of biliary and pancreatic ducts and duodenal gleam are analysed. The working classification of these diseases is developed. There are investigated frequency, the structure and reasons of development of postoperative complications at obstruction of pancreatoduodenal zone and is made their ordering with the help of additional laboratory researches of the most informatic prognostic factors: citokines 1 , 2, 4, 6, 8, TNF , oncomarker Са-19-9, antibodies to pancreas, elastase, and also morphological researches of pancreatic and liver byoptates with revealing of early attributes of phibrosis development in obstructive zone, namely - stellate сells. The algorithm of the forecast of development of postoperative complications with a choice of surgical tactics, and also algorithm of diagnostics and surgical treatment of obstructive diseases of pancreatoduodenal zone with application developed of 3-steps surgical tactics, miniinvasive and bodiesaving operative procedures, program of perioperative preventive maintenance of postoperative complications is developed. Introduction of the specified surgical techniques and rational tactics have allowed to reduce quantity of postoperative complications from 43,3 % up to 24,1 %, considerably by reducing their weight, and also postoperative mortality from 9,9 % up to 4,5%.