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Objective. Elaboration of method for the intraoperative ischemic-reperfusion trauma softening - distant ischemic preconditioning and investigation of results of its introduction into clinical practice. Materials and methods. The method of distant ischemic preconditioning elaborated have included four procedures the air inflation into the flap for the arterial pressure measuring by 40 mm Hg over the level of systolic arterial pressure, 5 min of duration in every one, with consequent 5-minute intervals for the air release from the flap. The procedure of a distant ischemic preconditioning was conducted after introduction into narcosis, but before the donor's nephrectomy in 30 patients (the main group). The procedure was not conducted in 30 such patients. Results. The procedure elaborated permits to enhance the glomerular filtration significantly in 6 and 12 mo, to reduce the rate of partial delay of the transplant functioning, its acute rejection and primary dysfunction. Conclusion. The procedure of a distant ischemic preconditioning elaborated improves the transplanted kidney function.

Possibilities of various diagnostic methods for biliary hypertension detection in chronic pancreatitis were analyzed. Biliary hypertension was revealed in 163 (31%) patients, suffering chronic pancreatitis. The laboratory investigations data, ultrasonographic investigation, computer tomography, endoscopic retrograde cholangiopancreatography, magnet-resonance cholangiopancreatography, intraoperative measurement of the biliary ducts width, intraoperative measurement of biliary pressure were applied for diagnosis. Endoscopic retrograde cholangiopancreatography, magnet-resonance cholangiopancreatography and intraoperative measurement of biliary pressure are considered the most sensitive methods for chronic pancreatitis diagnosis.

Objective. To estimate the results of performance of extended pancreatic resection in treatment of patients, suffering pancreatic tumors. Маterials and methods. In 2010 – 2016 yrs 545 patients were operated for pancreatic adenocarcinoma, distal pancreatic resection was performed in 127 (23.3%) of them, pancreaticoduodenal resection (PDR) – in 402 (73.8%), total pancreatectomy – in 16 (2.9%). Extended pancreatic resection was performed in 121 (22.2%) patients, including PDR – in 65 (53.7%), pancreatic distal resection – in 46 (38%), pancreatectomy – in 10 (8.3%). Results. Complications have had occurred in 167 (39.4%) patients after standard pancreatic resection and in 51 (42.1%) – after the extended one (c2 = 0.29, p = 0.58). Lethality was 2.6% (14 patients died), of them 5 (4.1%) – after extended pancreatic resection, 9 (2.1%) – a standard one (c2 = 1.52, p = 0.22). Survival median and the general five–year survival indices are nontrustworthy lesser in patients after extended pancreatic resection than after a standard one – 21 mo and 26% and 28 mo and 29% (c2 = 0.15, p = 0.69), accordingly. Conclusion. Lethality, morbidity rate, remote results after extended pancreatic resection are comparable with those after its standard resection.