The early and late results of distal pacreatic resection
Objective. To study up the early and late results of distal pancreatic resection with the aim to improve diagnosis and surgical treatment of the distal pancreatic segment disease.
Маterials and methods. Resectional interventions on distal pancreatic segment were performed in 19 patients in Department of General Surgery of Ivano-Frankivsk Regional Clinical Hospital in 2013 - 2017 yrs. In 12 (63.2%) patients the complicated forms of chronic pancreatitis (CHP) were diagnosed, and in 7 (36.8%) – pancreatic neoplasia. For diagnosis of pathological changes in corpora-caudal pancreatic segment there were applied laboratory investigations, ultrasound investigation, computed tomography, magnet-resonance tomography, pathohistological investigation of operational material.
Results. In CHP a DR, using anterior operative access, was performed in 7 patients, and using a posterior one - in 5. For pancreatic neoplasia a standard DR was done in 3 patients, a radical one – in 1, radical antegrade module (RAMPS) - 2, and applying a laparoscopic operative access – in 1 woman-patient. Postoperative complications have occurred in 6 (31.6%) patients. Late results were followed-up in 13 (68.4%) patients in 6 mo – 5 yrs terms: after DR for CHP – in 9, after DR for tumors – in 4. Good late results were obtained in 7 (77.7%) patients after DR for CHP and in 2 (50.0%) – for tumors, satisfactory results – in 2 (22.3%) and in 1 (25.0%) patients, accordingly, and poor result - in 1 (25.0%) after pancreatic DR, performed for malignant tumor.
Conclusion. Complex diagnosis of the distal pancreatic segment diseases with obligatory application of computed tomography gives possibility to establish strict indications for operation and to select a mostly adequate method of surgical intervention individually. Laparoscopic pancreatic DR constitutes a perspective method of surgical treatment in patients with CHP and locally-spread pancreatic neoplasia, it has good and fair early and late results. Resectional interventions on distal pancreatic segment leads to the diabetes mellitus occurrence in 16.6% of the patients.
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