Effect of different pancreatic stump closure techniques during distal pancreatectomy to the frequency and severity of acute postoperative pancreatitis

The Aim: to study the effect of different pancreatic stump closure techniques, including depending on the diameter of the main pancreatic duct to frequency and severity of acute postoperative pancreatitis after distal pancreatectomy. Material and Methods. Distal pancreatectomies were performed in 126 patients with neoplasms of the body and/or tail of the pancreas. Patients were divided into 4 groups depending on the pancreatic stump closure techniques. Group 1 (control): isolated suturing of the main pancreatic duct of the pancreatic stump with its sealing by gastrocolic omentum or hemostatic sponge; group 2: isolated suturing of the main pancreatic duct of the pancreatic stump with its sealing by biological glue 2-octylcyanoacrylate; group 3: pancreatic stump closure were performed by Endoscopic Linear Cutter; group 4: after distal pancreatectomy were performed external transduodenal transnasal drainage of the enlarged main pancreatic duct of pancreatic stump. Results. The frequency of acute postoperative pancreatitis in the control group of patients was 45.8%, in the group 2 of patients — 44.4%, in the group 3 of patients — 9.7%, in the group 4 of patients — 15.0%. The use of the proposed pancreatic stump closure techniques after distal pancreatectomy resulted in a decrease of the frequency of moderate form of acute postoperative pancreatitis. The use of Endoscopic Linear Cutter and external transduodenal transnasal drainage of the enlarged main pancreatic duct resulted in decrease of frequency of acute postoperative pancreatitis in patients with a diameter of the main pancreatic duct of the pancreatic stump up to 5 mm. Conclusion. The use of the proposed pancreatic stump closure techniques after distal pancreatectomy resulted in the decrease of frequency and severity of acute postoperative pancreatitis.</p

Recent advances in neutrinoless double beta decay search

Even after the discovery of neutrino flavour oscillations, based on data from atmospheric, solar, reactor, and accelerator experiments, many characteristics of the neutrino remain unknown. Only the neutrino square-mass differences and the mixing angle values have been estimated, while the value of each mass eigenstate still hasn't. Its nature (massive Majorana or Dirac particle) is still escaping. Neutrinoless double beta decay ($0\nu$-DBD) experimental discovery could be the ultimate answer to some delicate questions of elementary particle and nuclear physics. The Majorana description of neutrinos allows the $0\nu$-DBD process, and consequently either a mass value could be measured or the existence of physics beyond the standard should be confirmed without any doubt. As expected, the $0\nu$-DBD measurement is a very difficult field of application for experimentalists. In this paper, after a short summary of the latest results in neutrino physics, the experimental status, the R&D projects, and perspectives in $0\nu$-DBD sector are reviewed.Comment: 36 pages, 7 figures, To be publish in Czech Journal of Physic

Results of application of the PTFE-conduits in the reconstruction of the main veins of the abdominal cavity mesenteric-portal system in locally advanced pancreatic cancer

Aim: study of immediate and long-term results of the surgical treatment of the locally advanced pancreatic cancer with tumor invasion of the main veins of the abdominal cavity. Material and methods. Pancreaticoduodenectomy with resection and plasty of the main veins of the abdominal cavity were performed 315 patients. 143 patients underwent for prosthetics of the main veins at their reconstruction of different vascular prosthesis. Patients have been divided into three groups. Group I (basic) — PTFE-conduits have been used in the reconstruction of the main veins (82 patients). Group II — FLL-conduits have been used in the reconstruction of the main veins (36 patients). Group III — autovenous conduits have been used in the reconstruction of the main veins (25 patients). Comparison of the duration of operation and its reconstruction stage, the quantity of blood loss, frequency of venous thrombosis in the early postoperative period and long-term patency of the reconstructed veins traced ultrasonic method in a period of 6 months, 1, 2, and 3 years after surgery have been carried. The morbidity, the frequency of the infectious complications, the hospital mortality, the mean postoperative hospital stay, median of survival have been studied after surgery. Results. Application of the PTFE-conduits resulted for decrease of the duration of the reconstruction stage of the operation, as well as the duration of the surgery and the amount of intraoperative blood loss. Decrease of the morbidity, of the postoperative hospital stay and the mortality have been noted in the I group of patients compared to groups II and III patients. Thrombosis of the prosthesis after reconstruction of the veins that led for fatal outcome has been marked in 2 patients (5.5%) in group II of the patients. The long-term patency of vascular PTFE-conduits and reconstructed veins in group 1 has been 100% in all period's observations in the postoperative period. Conclusion. PTFE-conduits are universal plastic material. Application of the PTFE-conduits for the reconstruction of the main veins of the mesenteric-portal system can reduce the duration of the reconstruction vascular stage and the operation as a whole. Applications of the PTFE-conduits reduce the morbidity, the frequency of infectious complications, postoperative hospital-stay, hospital mortality, as well as improved performance patency of the reconstructed vessels