Novosti
Khirurgii
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indexed in Scopus



Year 2017 Vol. 25 No 3

ONCOLOGGY

DOI: https://dx.doi.org/10.18484/2305-0047.2017.3.286   |  

I.V. MIKHAILOV1, V.M. BONDARENKO2, T.N. NESTEROVICH1, V.A. KUDRYASHOV2, S.L. ACHINOVICH.2

SURGICAL TREATMENT RESULTS OF CANCER OF THE PANCREATIC HEAD DEPENDING ON PREOPERATIVE BILIARY DRAINAGE

EE "Gomel State Medical University"1,
E "Gomel Regional Clinical Oncology Dispensary"2,
Gomel
The Republic of Belarus

Objectives. To determine the impact of preoperative biliary drainage (PBD) on the surgical treatment results of patients with the pancreatic head cancer.
Methods. Short-term surgical treatment results were evaluated in 87 patients with cancer of the pancreatic head who undergo the operation on (March 1994 February 2016). The group I includes 40 patients with pancreatoduodenectomy without preoperative biliary drainage (PBD), group II 47 patients with pancreatoduodenectomy and with preoperative biliary drainage for the obstructive jaundice. Long-term results were evaluated in 38 patients of the first group and 41 patients of the second group.
Results. Post-operative complications occurred in 14 (35,0%) patients of the group I and 20 (42,5%) patients of the group II. The most frequent complication was pancreatitis of the stump, including the development of the pancreatojejunoanastomosis leakaqe (PJA). 1 (2,5%) patient of the group I and 4 (8,5%) patients of the group II died (P=0,22). No statistically significant differences for incidence rates complications in the patients of the studied groups were not revealed. Most important factors affecting the long-term results were similar clinical-morphological factors as PBD, histological type and the degree of the tumor differentiation. Significantly higher survival rates were obtained among the patients who underwent one-step surgical treatment (group I). The survival median time for the patients of the I and II groups, taking into account the postoperative lethality made 15,0 and 11,5 months, 3-year survival 33,47,8% and 3,23,1%, 5-year survival 26,77,5% and 0% respectively.
Conclusion. The extremely low survival rate of patients underwent two-step treatment testifies to the expediency of extension for the indications of one-step surgery for cancer of the pancreatic head, complicated by the obstructive jaundice.

Keywords: cancer of the pancreas head, gastropancreatoduodenectomy, biliary drainage, survival rates, pancreatojejunoanastomosis failure, complications, lethality
p. 286-291 of the original issue
References
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  4. van der Gaag NA, Rauws EA, van Eijck CH, Bruno MJ, van der Harst E, Kubben FJ, et al. Preoperative biliary drainage for cancer of the head of the pancreas. N Engl J Med. 2010 Jan 14;362(2):129-37. doi: 10.1056/NEJMoa0903230.
  5. Furukawa K, Shiba H, Shirai Y, Horiuchi T, Iwase R, Haruki K, et al. Negative Impact of Preoperative Endoscopic Biliary Drainage on Prognosis of Pancreatic Ductal Adenocarcinoma After Pancreaticoduodenectomy. Anticancer Res. 2015 Sep;35(9):5079-83.
Address for correspondence:
246012, Republic of Belarus,
Gomel, Medicinskaya, 2, Gomel State Medical University,
Department of oncology
tel.: 375 29 7346860,
e-mail: igor-mikhailov-2014@yandex.ru,
Igor V. Mihailov
Information about the authors:
Mikhailov I.V. PhD, Ass. Professor, Head of department of the oncology, EE "Gomel State Medical University".
Bondarenko V.M. Oncosurgeon of the oncologic abdominal department, E "Gomel Regional Clinical Oncology Dispensary".
Nesterovich T.N. Assistant of department of the oncology, EE "Gomel State Medical University".
Kudryashov V.A. Head of oncologic abdominal department of E "Gomel Regional Clinical Oncology Dispensary".
Achinovich S.L. PhD, Head of pathoanatomical department of E "Gomel Regional Clinical Oncology Dispensary".
Contacts | ©Vitebsk State Medical University, 2007