METHOD OF CHOOSING TACTICS OF ARTERIAL VASCULAR RECONSTRUCTION WITH THE TRANSPLANTATION OF PANCREAS GLAND

FIELD: medicine.SUBSTANCE: invention relates to medicine, namely to transplantology. Length of a donor stump of superior mesenteric artery (SMA) pancreas gland (PG) is evaluated. In case the SMA stump has a length of more than 0.5 cm, a reconstruction using a V-shaped vascular insert is performed, anastomizing its ends with the SMA stump, stump of the splenic artery of the transplant and a common iliac artery of the recipient. In case the donor pancreas gland has SMA stump of a length equal to or less than 0.5 cm, the presence and severity of intraorgan arterial collaterals is evaluated. For this purpose, the pancreas gland is washed with a preservative solution of 100-500 ml, injected through the splenic artery. And when a half or more of the preservative solution is injected into the splenic artery from the lumen of the SMA, the SMA stump is bandaged, after which the length of the iliac artery stump is evaluated. In case its length is equal to or more than 1 cm, an arterial reconstruction is performed, anastomosing the splenic artery of the pancreas gland with the common iliac artery of the recipient in the "end-to-side" type. In case the length of the iliac artery stump is less than 1 cm, it is lengthened using the corresponding portion of the external or general iliac artery of the donor. Then, an anastomosis is formed between the elongated splenic artery of the donor and the common iliac artery of the recipient in the "end-to-side" type, followed by draining and suturing the wound.EFFECT: method allows to reduce the time of surgical intervention, reduce the time of cold ischemia of the transplant and, as a result, the degree of damaged organ ischemia, to accelerate the patient's rehabilitation time, as well as to shorten the period of hospitalization, reduce the risk of developing arterial thrombosis of the prostate graft, expand the criteria for the removal of the prostate, thereby increasing the number of operations for transplantation of the prostate.1 cl, 2 ex, 2 dwg Изобретение относится к области медицины, а именно к трансплантологии. Выполняют оценку длины культи верхней брыжеечной артерии донорской (ВБА) поджелудочной железы (ПЖ). В том случае, если культя ВБА имеет длину более 0,5 см осуществляют реконструкцию с использованием У-образной сосудистой вставки, анастомозируя ее концы с культей ВБА, культей селезеночной артерии трансплантата (СА) и общей подвздошной артерией реципиента. В том случае, если донорская ПЖ имеет культю ВБА длиной, равн