Some aspects of formation of the biliodigestive anastomosis at tumours of the head of the pancreas and periampullary zones

With the purpose of improvement of the nearest postoperative results of treatment of patients by a mechanical jaundice research of 293 patients malignant neoplasms the head of a pancreas and periampullary zones by which operations biliary-enteric shunting have been made has been lead. The volume of operation has been caused by prevalence of tumorous process (stage IVa and IVb), or presence at the patient of contra-indications to performance pancreatic duodenal resections (age, weight of a somatic pathology). Frequency of occurrence of postoperative complications after primary roundabout cholecystoenterostomy (i.e. without preliminary decompression bilious ways) has made 12,7 %, and after same hepaticoenterostomy - 20,0 %. Postoperative lethality has made accordingly 6,3 % and 5,0 %. In groups of comparison, i.e. with preliminary unloading bilious ways, patients with complications were in 1,3-1,7 times more, and frequency of death in a hospital for them in 2 times was higher. Operations on creation roundabout hepaticoenteroanastomosis give the greater interest of early postoperative complications and do not increase life expectancy of patients in comparison with roundabout cholecystoenterostomy.