Novosti
Khirurgii
This journal is
indexed in Scopus



Научно-практическая конференция с международным участием и
XXVIII Пленум Правления Белорусской ассоциации хирургов
«Актуальные вопросы и современные подходы в оказании
хирургической помощи в Республике Беларусь»
18-19 ноября 2021 года в г. Минск.






Year 2011 Vol. 19 No 5

GENERAL AND SPECIAL SURGERY

M.I. KUGAEV, I.V. SAMSONOVA, V.A. KLOPOVA, I.A. BEKHTEREVA, A.E. DOROSEVICH

INTERCONNECTION OF THE NERVOUS TISSUE LESION AND FIBROUS CHANGES IN THE PANCREAS HEAD WITH PAIN SYNDROME AND LIFE QUALITY OF PATIENTS AT CHRONIC PANCREATITIS

Objectives. To study the interconnection of the nervous tissue lesion in the head of the pancreas with the degree of fibrous changes as well as with the level of pain syndrome and life quality of patients with chronic pancreatitis (CP).
Methods. 37 patients with CP were examined in whom duodenum saving resection of the pancreas head was performed. The visual analogous scale (VAS) was used to evaluate the intensiveness of the pain syndrome; the questionnaire SF-36 was applied to study life quality. The area of the histological preparation, the area of each nervous structure, the number of nerves and total area of the nervous tissue were evaluated at the microscopic research.
Results. The area of the nervous tissue was reliably smaller at the 1st degree of fibrosis in comparison with the 2nd and 3rd ones. The area of the nervous tissue at the 2nd and 3rd degrees of fibrosis didnt differ significantly. While comparing the number of nerves depending on the fibrosis area it was found out that the number of nerves differs significantly at the 1st and 3rd degrees of fibrosis. While comparing the 1st and 2nd as well as the 2nd and 3rd these differences were unreliable. While comparing the area median of one nerve, one revealed no dependence on the fibrous changes. The area of the nervous tissue, numbers of nerves, area median of one nerve don, t correlate with the quality life scales as well as they don, t depend on the pain syndrome level.
Conclusions. At chronic pancreatitis the lesion of the nervous tissue in the pancreas head depends on the degree of the fibrous changes. Proportion increase of the nervous tissue area to the pancreas tissue occurs due to the number of the nervous elements increase. The marked character of the pain syndrome and life quality doesn, t depend on the nervous tissue lesion.

Keywords: chronic pancreatitis, pancreas fibrosis, life quality, intensiveness of pain syndrome, nervous tissue area
p. 39 – 45 of the original issue
References
  1. Course and outcome of chronic pancreatitis: Longitudinal study of a mixed medical-surgical series of 245 patients / R. W. Ammann [et al.] // Gastroenterology. – 1984. – Vol. 86. – P. 820-828.
  2. Goebell, H. Beginn und Entwicklung der chronischenPankreatitis / H. Goebell // Internist. – 1986. – Vol. 27. – P. 172-174.
  3. Clinical course and prognosis of chronic pancreatitis / H. Miyake [et al.] // Pancreas. – 1987. – Vol. 2. – P. 378-385.
  4. Lankisch, P. G. Natural Course of Chronic Pancreatitis / P. G. Lankisch // Pancreatology. – 2001. – Vol. 1. – P. 3-14.
  5. Keith, R. G. Neuropathology of chronic pancreatitis in humans / R. G. Keith, S. H. Keshavjee, N. R. Kerenyi // Can. J. Surg. – 1985. – Vol. 28. – P. 207-211.
  6. Analysis of nerves in chronic pancreatitis / D. E. Bockman [et al.] // Gastroenterology. – 1988. – Vol. 94. – P. 1459-1469.
  7. Changes in peptidergic innervation in chronic pancreatitis / M. Buchler [et al.] // Pancreas. – 1992. – Vol. 7. – P. 183-192.
  8. Immune cell infiltration and growth- associated protein 43 expression correlate with pain in chronic pancreatitis / P. Di Sebastiano [et al.] // Gastroenterology. – 1997. – Vol. 112. – P. 1648-1655.
  9. Neural alterations in surgical stage chronic pancreatitis are independent of the underlying aetiology / H. Friess [et al.] // Gut. – 2002. – Vol. 50. – P. 682-686.
  10. Кугаев, М. И. Взаимосвязь патоморфологических изменений в головке поджелудочной железы с интенсивностью болевого синдрома и качеством жизни / М. И. Кугаев, А. Т. Щастный, И. В. Самсонова // Новости хирургии. – 2011. – Т. 19, № 2. – С. 31-36.
  11. Коржевский, Д. Э. Основы гистологической техники / Д. Э. Коржевский, А. В. Гиляров. – СПб.: СпецЛит, 2010. – 96 с.
  12. Expression of interleukin 8 (IL-8) and substance P in human chronic pancreatitis / P. Di Sebastiano [et al.] // Gut. – 2000. – Vol. 47. – P. 423-428.
  13. Nerve growth factor expression is up-regulated in the rat model of L-arginine-induced acute pancreatitis / H. Toma [et al.] // Gastroenterology. – 2000. – Vol. 119. – P. 1373-1381.
  14. Nerve growth factor and its high affinity receptor in chronic pancreatitis / H. Friess [et al.] // Ann. Surg. – 1999. – Vol. 230. – P. 615-624.
  15. Growth associated protein-43 and protein gene product 9.5 innervation in human pancreas: changes in chronic pancreatitis / T. Fink [et al.] // Neuroscience. – 1994. – Vol. 63. – P. 249-266.
  16. Pain mechanisms in chronic pancreatitis: of a master and his fire / I. E. Demir [et al.] // Langenbecks Arch. Surg. – 2011. – Vol. 396. – P. 151-160.
Contacts | ©Vitebsk State Medical University, 2007