Criteria of volume of local pancreatic resection in patients with chronic fibrous-degenerative pancreatitis


Keywords: chronic pancreatitis; pancreatic hypertension

Abstract

Oblective. Substantiation of the pancreatic gland local resection and elaboration of algorithm for surgical treatment of chronic fibrous-degenerative pancreatitis (CHFDP).

Маterials and methods. Results of surgical treatment of 69 patients, suffering CHFDP, complicated by syndrome of pancreatic hypertension, were analyzed. In 6 patients a local pancreatic gland resection was accomplished in accordance to Frеy procedure, in 2 – to Izbicki procedure, in 52 - to Frеy-Izbicki procedure, and in 9 – pancreaticoduodenal resection.

Results. The advantage must be given to Frеy-Іzbicki procedure, because it makes impossible to eliminate the chronic pancreatitis pacemaker completely – a zone of maximal pancreatic fibrosis. Postoperative morbidity have occurred in 17.4% patients. Postoperative mortality was absent.

Conclusion. The occurrence rate for pancreatic hypertension after Frеy-Izbicki procedure is reduced by 11.1%.

References

1. Machicado JD, Rebours V, Yadav D. Epidemiology of Chronic Pancreatitis. Pancreapedia: Exocrine Pancreas Knowledge Base [Internet]. 2016 July; 28. Available from: https://www.pancreapedia.org/reviews/epidemiology-of-chronic-pancreatitis. doi: 10.3998/panc.2016.13.

2. Kanikovskiy OE, Pavlyk IV, Oliinyk IV. The severity of pancreatic fibrosis - independent factor for choosing of type of surgical treatment in patients with chronic pancreatitis. Pancreatology. 2018 June;18(4 Suppl), S167. doi.org/10.1016/j.pan.2018.05.452.

3. Kanikosky OE, Pavlyk IV, Androsov SI, Ruban MM, Babiychuk UV, Gnatuk U, et al. Definition of local resection margins in patients with chronic pancreatitis. 47 World Congress of Surgery 2017. Abstract book. 2017. P.302 (96.05).

4. Anderson MA, Akshintala V, Albers KM, Amann ST, Belfer I ,Brand R, et al. Mechanism, assessment and management of pain in chronic pancreatitis: Recommendations of a multidisciplinary study group. Pancreatology. 2016 Jan-Feb;16(1): 83-94. doi: 10.1016/j.pan.2015.10.015.

5. Ito T, Ishiguro H, Ohara H, Kamisawa T, Sakagami J, Sata N, et al. Evidence-based clinical practice guidelines for chronic pancreatitis 2015. J Gastroenterol. 2016 Feb;51(2):85-92. doi: 10.1007/s00535-015-1149-x.

6. Majumder S, Chari ST. Chronic pancreatitis. Lancet. 2016 May;387(10031):1957-66. doi: 10.1016/S0140-6736(16)00097-0.

7. Whitcomb DC, Frulloni L, Garg P, Greer JB, Schneider A, Yadav D, et al. Chronic pancreatitis: An international draft consensus proposal for a new mechanistic definition. Pancreatology. 2016 Mar-Apr;16(2):218–24. doi: 10.1016/j.pan.2016.02.001

8. Bellin MD, Beilman GJ. Surgical trials for chronic pancreatitis. Lancet. 2017 Sep 9; 390(10099):1007-8. doi: 10.1016/S0140-6736(17)32338-3

9. Issa Y, van Santvoort HC, van Dieren S, Besselink MG, Boermeester MA, Ahmed Ali U. Diagnosing Chronic Pancreatitis: Comparison and Evaluation of Different Diagnostic Tools. Pancreas. 2017 Oct; 46(9):1158-64. doi: 10.1097/MPA.0000000000000903.

Author Biographies


O. E. Kanikovskyi, National Pirogov Memorial Medical University, Vinnytsya

Kanikovskyi Oleh Evgeniyovych MD, PhD, professor

Head of Department of surgery of medical faculty 2

National Pirogov memorial Medical University, Vinnytsya.

Adress: 56, Pyrogov str., Vinnytsya, 21031

E-mail: o.kanikovsky@gmail.com

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


I. V. Pavlyk, National Pirogov Memorial Medical University, Vinnytsya

Pavlyk Ihor Vasylyovych MD, 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, National Pirogov Memorial Medical University, Vinnytsya

Oliinyk Iryna Vasylivna MD, PhD, associated professor

Associated professor of Department of Public Health

National Pirogov memorial Medical University, Vinnytsya.

Adress: 56, Pyrogov str., Vinnytsya, 21031,

E-mail: oliynyk.iv@gmail.com

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


O. L. Mahovskyi, National Pirogov Memorial Medical University, Vinnytsya

Mahovskyi Oleksandr Leonidovych MD

Trainee of Department of surgery of medical faculty 2

National Pirogov memorial Medical University, Vinnytsya.

Adress: 56, Pyrogov str., Vinnytsya, 21031

E-mail: ipavlyk@gmail.com

ORCID: https://orcid.org/0000-0003-2969-7780

Published
2018-12-28
How to Cite
Kanikovskyi, O. E., Pavlyk, I. V., Oliinyk, I. V., & Mahovskyi, O. L. (2018). Criteria of volume of local pancreatic resection in patients with chronic fibrous-degenerative pancreatitis. Klinicheskaia Khirurgiia, 85(12), 13-15. https://doi.org/10.26779/2522-1396.2018.12.13
Section
General Problems of Surgery