[Choice of surgical procedure in operations for XXXX --personal experience].

@entity1 @entity788 @entity82 @entity6 @entity5 @entity1689 @entity260 @entity2054 @entity86 @entity3147 @entity9528
The First Surgical Clinic of the First Medical Faculty of Charles University and General Faculty Hospital in Prague made operations of the pancreas ever since 1971. In the work sooner or later all approaches to surgical treatment @entity788 were reflected. The authors present a brief review of results and their own experience since 1994 when duodenum-sparing operations were introduced. Indications for surgical treatment were based on the diagnosis by US, CT and ERCP, in exceptional case MR, after evaluation by a pancreatologist, roentgenologist and surgeon. The group of @entity1 with @entity1689 was extended by 21 @entity1 from a group operated because of preoperative suspicion of a malignant @entity5 not confirmed during and after surgery. In those Whipple's operation was preformed. The same operation was performed in three @entity1 with @entity1689 with serious changes in the area of the head of the pancreas. In 123 @entity1 a drainage and duodenum sparing operation was preformed, of these in 57 according to Beger, 19 according to Frey, 37 Partington-Rochelle's procedure. The authors record two @entity260 after the classical Beger operation and the hospital stay was on average by five days shorter as compared with the classical method of Whipple. When evaluating @entity86 ( @entity86 , @entity3147 , physical @entity9528 and social position) the authors recorded equally favourable results as after non-complicated duodenopancreatectomy. They varied, depending on the @entity1 co-operation round 84-87% while authors consider Beger's operation logical because of the removal of the main tissue mass of the head of the pancreas, responsible for @entity86 , complications caused by @entity82 in the area round the bile duct and duodenum, responsible for the deteriation of the @entity2054 in the left half of the gland. Its result is destruction of the remainder of exocrine and endocrine tissue. Of 187 operated @entity1 one @entity1 with decompensated @entity6 died postoperatively. Based on their own experience the authors do not consider repeated re-operations an absolute contraindication of Beger's operation when conditions permit. A problem is, in their opinion, @entity82 in the vicinity of the pancreas and portal overpressure.
