Estimation of variants of the pancreatic gland pathology in patients, suffering complicated forms of chronic pancreatitis in late postoperative period

Abstract

Objective. Estimation of variants of the pancreatic gland pathology and rate of the unfavorable results occurrence in late postoperative period in patients, suffering complicated forms of chronic pancreatitis, depending on the procedures of surgical treatment.
 Materials and methods. Results of surgical treatment of complicated forms of chronic pancreatitis in department of the gut surgery in 2007 - 2017 yrs were studied in 107 patients, who were divided into two groups: the Group I – 67 (62.7%) patients, in whom pancreato- and virsungodigestive operations were performed, and the Group II – 40 (37.4%) patients, in whom duodenum—preserving resection-drainage surgical interventions were done.
 Results. Unfavorable variants of pancreatic pathology were observed significantly more frequently in patients of the Group I – in 34/67 (50.7%) in comparison with patients of the Group II – in 6/40 (15.0%) (χ2=9.49, p=0.002).
 Conclusion. Analysis of rate of the unfavorable results occurrence in late postoperative period, depending on surgical tactics appled, have shown a trustworthy advantage of the resection-drainage operations.

Pancreatoduodenal resection in the treatment of complicated forms chronic pancreatitis

“…Выбор методики оперативного вмешательства зависит от конкретных морфологических изменений ПЖ, которые определяют клиническую симптоматику и течение заболевания [5]. У 6 пациентов выполнена ультразвуковая эластография, которая показала наличие фиброза в области головки и тела ПЖ у данной группы больных.…”

“…ОБСУЖДЕНИЕ ХП повышает риск развития рака ПЖ в 9-16 раз. Основная роль в развитии хрони-ческого панкреатита и рака ПЖ принадлежит панкреатическим звездчатым клеткам (PSC), которые участвуют в формировании фиброза и стимуляции онкогенеза[5,6]. Проведение дифференциального диагноза между осложненными формами ХП и опухолью головки как на дооперационном, так и интраоперационном этапе, может быть достаточно сложным.…”