title: [Pancreaticoduodenal resection in the treatment of malignant periampullar tumors].
abstract: The experience of performance of pancreaticoduodenal resection (PDR) in 412 patients in 1998-2009 yrs for malignant periampullar tumors was analyzed. In 296 patients a standard PDR was done and in 116, with tumoral affection of distal part of common biliary duct and duodenal large papilla - pylorus-preserving PDR Individualized approach was used, exploiting modern technologies of pylorus-preserving PDR: saving gastroduodenal artery, selective ligation of right branch of dorsal pancreatic and lower pancreatoduodenal artery, dorsal and translateral surgical approaches usage. In 26 patients PDR was accomplished with resection of vessels. In 12 patients a no-touch procedure of PDR was applied. There were analyzed the results of application of modified extended lymphadenectomy while PDR performance. Complications had occurred in 29.5% patients, lethality was 2.7%. The survival indices had constituted at average 24 mo--in pancreatic tumors, 48 mo--in tumors of a distal part of common biliary duct and 72 mo--for localized in duodenal large papilla. Introduction of a new methods of PDR would permit to improve an early and late results of treatment.
authors.forename: V M
authors.initials: VM
authors.lastname: Kopchak
authors.forename: K V
authors.initials: KV
authors.lastname: Kopchak
authors.forename: A V
authors.initials: AV
authors.lastname: Duvalko
authors.forename: A I
authors.initials: AI
authors.lastname: Zelinskiĭ
authors.forename: G G
authors.initials: GG
authors.lastname: Shevkolenko
authors.forename: B V
authors.initials: BV
authors.lastname: Borisov
authors.forename: Ia V
authors.initials: IaV
authors.lastname: Romaniv
authors.forename: A N
authors.initials: AN
authors.lastname: Domnich
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014670:Ampulla of Vater / Q000098:blood supply / Q000601:surgery*; D003138:Common Bile Duct Neoplasms / Q000098:blood supply / Q000601:surgery*; D004379:Duodenal Neoplasms / Q000098:blood supply / Q000601:surgery*; D005260:Female; D006801:Humans; D008197:Lymph Node Excision / Q000379:methods; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000098:blood supply / Q000601:surgery*; D016577:Pancreaticoduodenectomy / Q000379:methods*; D016896:Treatment Outcome