Clinical and morphological characteristic of the chronic pancreatitis pacemakers

Keywords: the chronic pancreatitis pacemaker

Abstract

Objective. To substantiate a concept of a chronic pancreatitis (CHP) pacemaker.

Маterials and methods. Results of surgical treatment in 181 patients, suffering CHP, complicated by pancreatic hypertension syndrome, were analyzed.

Results. There were 24.5% of the patients, admitted to hospital and suffering the pain syndrome type B, which indicates indirectly on total severe pancreatic fibrosis. In all the patients the multiple strictures of the main pancreatic duct were revealed clinically, as well as the tissue-іnstrumental pressure of resistance more than 26.7 kPa (200 mm Hg) and histologically - a square of the connective-tissue fields - was up to (81.4 ± 6.62)%. Тhus, a stricture ought to be regarded as the CHP pacemaker  - a zone of maximal fibrosis and calcium-creation in the main pancreatic duct, which is a principal one, and those of the second and third orders. Pancreatic head have served as the CHP pacemaker in 83.8% observations only, while the pancreatic neck and body - in 16.2%.

Conclusion. The key factor in surgical treatment of CHP is a wide excision of pancreatic stricture (zone of fibrosis), providing performance of combined local pancreatic resection in accordance to Frey-Izbicki procedure with the occurrence rate for the pancreatic hypertension recurrence lesser than 11.1%.

Author Biographies

O. E. Kanikovskyi

Kanikovskyi Oleh Evgeniyovych, MD, PhD, professor

Department of surgery of medical faculty 2

National Pirogov memorial Medical University, Vinnytsya.

Adress: 56, Pyrogov str., Vinnytsya, 21031, tel.: +38 (067)

E-mail: o.kanikovsky@gmail.com

ORCID: https://orcid.org/0000-0002-9302-8760

I. V. Pavlyk, Vinnytsya National Medical University named after М. І. Pyrogov

Pavlyk Ihor Vasylyovych, PhD, associated professor

Associated professor of Department of surgery of medical faculty 2

National Pirogov memorial Medical University, Vinnytsya.

Adress: 56, Pyrogov str., Vinnytsya, 21031, tel.: +38 (067) 419 46 82

E-mail: ipavlyk@gmail.com

ORCID: https://orcid.org/0000-0003-2018-273X

I. V. Oliinyk, Vinnytsya National Medical University named after М. І. Pyrogov

Oliinyk Iryna Vasylivna

PhD, associated professor

Associated professor of Department of Public Health

National Pirogov memorial Medical University, Vinnytsya.

Adress: 56, Pyrogov str., Vinnytsya, 21031, tel.: +38 (097) 2811914

E-mail: oliynyk.iv@gmail.com

ORCID: https://orcid.org/0000-0001-6034-3580

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Published
2018-09-30
How to Cite
Kanikovskyi, O. E., Pavlyk, I. V., & Oliinyk, I. V. (2018). Clinical and morphological characteristic of the chronic pancreatitis pacemakers. Klinicheskaia Khirurgiia, 85(9), 11-14. https://doi.org/10.26779/2522-1396.2018.09.11
Section
General Problems of Surgery