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Year 2011 Vol. 19 No 5
GENERAL AND SPECIAL SURGERY
DISTANT RESULTS OF THE PANCREAS PROXIMAL RESECTION IN PATIENTS WITH CHRONIC PANCREATITIS
Objectives. To analyze distant results of the pancreas proximal resection and to study the quality of patients, life in the postoperative period.
Methods. 153 patients with chronic pancreatitis (CP) were included in the research in whom pancreas proximal resections were performed (pancreatoduodenal resection in 53 patients; Bege, rs operation in modification of the clinic – in 61 patients; Bern, s modification – in 39 patients). Criteria of treatment efficacy were the level of distant lethality, frequency of complications and repeated interventions, marked character of exocrine and endocrine insufficiency. The pain syndrome level and professional rehabilitation of patients were estimated.
Results. Late lethality related to chronic pancreatitis progressing made up 2,61%. Firstly revealed diabetes mellitus developed in 15 (9,8%) patients after all surgical interventions; reliably smaller number of such cases in patients after Beger, s operation was noted in comparison with pancreatoduodenal resection. Exocrine insufficiency was revealed in 27 (17,65%) patients and it doesnt depend on the operative technique.
High level of professional rehabilitation was marked at all techniques which was achieved in 137 (89,54%) patients. There was a reliable improvement of parameters of the pain syndrome elimination after Beger, s operation in modification of the clinic in comparison with pancreatoduodenal resection.
Conclusions. The performed analysis of the distant results of surgical treatment of CP patients demonstrates advantages of the pancreas proximal resection with the duodenum saving.
- Steer, M. L. Chronic pancreatitis / M. L. Steer, I. Waxman, S. N. Freedman // Engl. J. Med. – 1995. – N 332. – P. 1482-1490.
- Chronic pancreatitis. Diagnosis and treatment / J. Mayerle [et al.] // Chirurg. – 2004. – Vol. 75. – P. 731-747.
- Adams, D. B. Outcome after lateral pancreaticojejunostomy for chronic pancreatitis / D. B. Adams, M. C. Ford, M. C. Anderson // Ann. Surg. – 1994. – Vol. 219. – P. 481-487. – Disc. 487-489.
- Prinz, R. A. Pancreatic duct drainage in 100 patients with chronic pancreatitis / R. A. Prinz, H. B. Greenlee // Ann. Surg. – 1981. – Vol. 194. – P. 313-320.
- Schlosser, W. Pseudocyst treatment in chronic pancreatitis – surgical treatment of the underlying disease increases the long-term success / W. Schlosser, M. Siech, H. G. Beger // Dig. Surg. – 2005. – Vol. 22. – P. 340-345.
- Pancreatic function and quality of life after resection of the head of the pancreas in chronic pancreatitis. A prospective, randomized comparative study after duodenum-preserving resection of the head of the pancreas versus Whipples operation / I. Klempa [et al.] // Chirurg. – 1995. – Vol. 66. – P. 350-359.
- The Whipple partial duodenopancreatectomy for the treatment of chronic pancreatitis / B. Rumstadt [et al.] // Hepatogastroenterology. – 1997. – Vol. 44. – P. 1554-1559.
- Six hundred fifty consecutive pancreaticoduodenectomies in the 1990s: pathology, complications, and outcomes / C. J. Yeo [et al.] // Ann. Surg. – 1997. – Vol. 226. – P. 248-257. – Disc. 257-260.
- Assessment of the quality of life in chronic pancreatitis using Sf-12 and EORTC Qlq-C30 questionnaires / R. Pezzilli [et al.] // Digestive and Liver Disease. – 2007. – Vol. 39. – P. 1077-1086.
- Clinical, Emotional and Social Factors Associated with Quality of Life in Chronic Pancreatitis / A. Mokrowiecka [et al.] // Pancreatology. – 2010. – Vol. 10. – P. 39-46.
- Long-term follow-up of a randomized trial comparing the beger and frey procedures for patients suffering from chronic pancreatitis / T. Strate [et al.] // Ann. Surg. – 2005. – Vol. 241. – P. 591-598.
- Щастный, А. Т. Проксимальная резекция поджелудочной железы по Бегеру – ее технические аспекты и модификации / А. Т. Щастный // Медицина. – № 2. – C. 23-27.
- Duodenum-preserving head resection in chronic pancreatitis changes the natural course of the disease: a single-center 26-year experience / H. G. Beger [et al.] // Ann. Surg. – 1999. – Vol. 230. – P. 512-519.