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In the period from 2011 till 2012 the Otcreotide-depot was used by the authors in treatment of 34 patients. The patients were divided into two groups: the first group--the prevention of development and the second group--the treatment of external pancreatic fistulas. Ocreotide-depot was applied in 17 patient of the first group: as part of the complex therapy of severe pancreatitis in 4 patients and after pacreaticoduodenectomy in 13 patients. Ocreotide-depot was used in 17 patients of the second group: 7 cases of patients after different types of pancreatic resections and after external drainage of pancreatic cysts in 10 patients. The positive effect of using the drug was obtained in 30 patients (88.25%): the cases of preventive application of drug in 17 patients and during the treatment of external pancreatic fistulas in 13 patients. The preventive and therapeutic usage of Ocreotide-depot facilitated an uncomplicated postoperative period in 13 cases and the healing of the external pancreatic fistulas in terms from 5 till 7 days in 13 patients. The application of Ocreotide-depot could be recommended as a preventive measure against the incompetence of pancreaticojejunoanastomosis after pancreaticoduodenectomy in complex therapy of severe pancreatitis and also in treatment of external pancreatic fistulas after pancreaticoduodenectomy and percutaneous drainage of postnecrotic pseudocysts.

Two groups of patients in whom two-stage treatment of cholecystocholedocholithiasis was performed with different succession of using endoscopic papillosphincterotomy (EPST) and laparoscopic cholecystectomy (LCE) were compared. In 59 patients (1st group) EPST was used as the first stage, in 67 patients (2nd group) LCE and drainage of choledochus preceded the endoscopic intervention. The effectiveness of EPST was 93.3 and 95.5% correspondingly in the first and second groups. There were no considerable differences in the frequency of complications, period of treatment at the hospital in the two groups. Lythextraction was obtained considerably more often at the first attempt in the second group of patients (79.1% versus 59.9%, p0.05). Due to inefficiency of EPST in three cases in the second group of patients reoperations were required. Thus, EPST should be performed before LCE for the rationally planned further treatment in case of its inefficiency.

In order to improve radicalism of emergency surgical interventions an appropriate method of total mesocolonectomy and D3-lymph node dissection in the medial-lateral direction and the principle of "no-touch technique" were used in 14 patients. This technique is safe, effective, does not prolong the duration of operation and postoperative period, is not followed by increased number of complications and lethality.

The authors have analyzed experience with treatment of pain syndrome in 45 patients, in 31 of them thoracoscopic sympathsplanchnectomy was fulfilled. The operation was shown to give a pronounced analgetic effect and improved quality of life of patients.

For the period from 2000 through 2007 there were 27 patients treated for lesions of extrahepatic bile ducts of different genesis. Since all the lesions were high, we have formed biliodigestive anastomoses on the exchangeable transhepatic drains by the method of Groetz-Saypol-Kurian. In a month after the operation and a standard management of the exchangeable transhepatic drains we departed from the classical technique and applied nonperforated drains. Using the nonperforated exchangeable transhepatic drains in patients after reconstructive operations on the extrahepatioc bile ducts gave good immediate results of operations and substantially improved quality of life of the patients in the postoperative period.