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Background/aims: The objectives of the research were to compare the outcomes of pancreatoduodenectomy (PD) (Kausch-Whipple or Traverso-Longmire) and resection with drainage operations (RDO) (Frey or Partingtone-Rochelle) in patients suffering from chronic pancreatitis (CP), in management of pain syndrome and quality of life provided by these kinds of surgical procedures., Methodology: From 2002 to 2008 sixteen patients suffering from CP underwent PD and 16 underwent RDO. Treatment results for the two groups were analyzed with respect to postoperative complications and results of the questionnaire MOS SF-36 v.2(TM)., Results: In the immediate postoperative period more complications were observed in the PD group (a<0.05). In both groups a positive effect on removing the painful syndrome and improvement of the quality of life (p<0.01) were observed. In the PD group there were the best results of management by General Health difference criterion (a<0.01). A greater improvement of Physical Functiong value (a<0.01) was noticed in patients who underwent RDO., Conclusions: Both PD and RDO adequately remove pain syndrome and improve the quality of life in patients suffering from CP. Under equal conditions the preference should be given to RDO, as improvement in life quality of operated patients is greater.

Purpose: To evaluate intravascular xenotransplantation of macroencapsulated pancreatic islet cells in the process of the treatment of diabetes mellitus type 1 without immunosuppressive therapy., Material and Methods: Xenogenic intravascular transplantation was performed in 19 patients with diabetes mellitus (type 1) having high insulin demand and frequent hypo- and hyperglycemic comas without immunosuppressive therapy. The culture was obtained from 3rd trimester rabbit fetuses. Cell culture suspension was encapsulated into microporous macrocapsule made of nylon and grafted into the deep femoral artery or the forearm cubital vein after performing arteriovenous anastomosis., Results: For 2 years after transplantation, positive results were observed in 14 recipients (73.7%). The total decrease of insulin demand was 60-65%, and hypo- and hyperglycemic comas disappeared completely, while C-peptide and immunoreactive insulin levels significantly increased, reversely correlating with the fructosamin level, as a protein glycation marker., Conclusions: Xenotransplantation of pancreatic islet cells with their subsequent grafting into the vascular lumen creates double immune isolation and allows overcoming acute and chronic graft rejection without immuno-suppressive therapy. It considerably decreases insulin demand, compensates hypo- and hyperglycemic conditions, makes the course of diabetes stable, and improves the quality of the patients' life.

Experimental dogs with alloxan-induced diabetes mellitus (n = 22) were transplanted into the abdominal aorta lumen with macroencapsulated xenogenic rabbit islet cells without immunosuppressive therapy. The investigation showed normalization of the blood glucose level and disappearance of diabetes mellitus symptoms. Morphological and immunohistochemical investigations 13 months later demonstrated preservation and functional activity of up to 60% of the transplanted islet cells. Meanwhile by month 6 a structure similar to the Islet of Langerhans had formed in the capsule. The majority of the mass of cells was insulin-positive by immunohistochemical investigation. The bloodstream appears to be an immune-privileged zone, where no graft rejection develops and long-term preservation-function of xenogenic islet cells may be possible. Macroencapsulated islets transplanted into the vascular lumen may form an endocrine apparatus of a bioartificial pancreas.

The article presents a new method of surgical treatment of experimental diabetes mellitus in a rabbit to dog model. Rabbit islet cells, which had been macroencapsulated into a microporous polyamide, were implanted into the dog aorta without immunosuppressive therapy. Euglycemia was reached at 4 to 5 days and persisted for 12 months. Morphological and immunohistochemical investigations showed long-term preservation of islet cell viability, absence of graft rejection, and formation of a biological artificial pancreas in the capsule at 6 months after transplantation. Up to 60% of transplanted cells were still viable 12 months later. The major factor contributing to preservation of islet cells is neo-angiogenesis, which develops during the first weeks after transplantation. Double immune isolation of islet cells by macroencapsulation with implantation into the blood stream allows the use of either xenotransplantation or allotransplantation.