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2008 г. №4 Том 16
ОБЩАЯ И ЧАСТHАЯ ХИРУРГИЯ
ЕГОРОВ В.И., ВИШHЕВСКИЙ В.А., КАРМАЗАHОВСКИЙ Г.Г., ЩЕГОЛЕВ А.И., ЯШИHА Н.И., ПАВЛОВ К.А., ДУБОВА Е.А., МЕЛЕХИHА О.В., ШЕВЧЕHКО Т.В.
ОПЫТ ДИАГHОСТИКИ И ЛЕЧЕHИЯ АУТОИММУHHОГО ПАHКРЕАТИТА.
Институт хирургии им. А.В. Вишневского,
Российская Федерация
В статье представлен первый в России опыт диагностики и лечения аутоиммунного панкреатита, а также литературные данные об этой патологии. Проведен ретроспективный анализ патогистологических препаратов и историй болезни 46 пациентов, перенесших панкреатодуоденальную резекцию в период с 1994 по 2007 гг. по поводу рака поджелудочной железы, который не был подтвержден при плановом гистологическом исследовании. На основании строгих морфологических критериев в 37 случаях были выявлены признаки хронического калькулезного, а в 9 случаях – аутоиммунного панкреатита. В одном наблюдении диагноз «аутоиммунный панкреатит» установлен на основании радиологических и серологических критериев, а эффективная стероидная терапия подтвердила его. Изучены демографические, клинические и радиологические признаки аутоиммунного панкреатита, а также ближайшие и отдаленные результаты оперативного и консервативного лечения.
Анализ полученных данных показал, что аутоиммунный панкреатит имеет определенную клинико-инструментальную картину, позволяющую заподозрить это заболевание после КТ или МРТ. Однако относительная редкость заболевания и недостаток информации о его проявлениях ограничивает возможности выявления как диффузных, так и локальных форм заболевания, а следовательно, их адекватного лечения.
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