Year 2012 Vol. 20 No 5

GENERAL AND SPECIAL SURGERY

A.T.SHASTNY 1, E. MATEVOSSIAN 2, D. DOLL 3

COMPARATIVE ASSESSMENT OF OPERATIVE TREATMENT RESULTS IN PATIENTS WITH CHRONIC PANCREATITIS AFTER BEGER’S OPERATION IN THE MODIFICA-TION OF THE CLINIC AND THE BERNE VARIANT OF BEGER’S OPERATION

EE “Vitebsk State Medical University”1,
The Republic of Belarus
Technical University of Munich 2, Munich,
Philipps-University of Marburg 3, Marburg,
Germany

Objectives. To analyze the results of two variants of duodenum-saving resection of the pancreas head with the traverse (Beger’s operation in the modification of the clinic) and without traverse (the Berne variant of Beger’s operation) of the pancreas over the portal vein in patients with chronic pancreatitis.
Methods. 82 patients are involved in the prospective research. Operative interventions were carried out in the period from 2008 up to 2011. Beger’s operation in our modification was performed in 39 (47,5%) patients, in 43 – the Berne variant of Beger’s operation. While carrying out the comparative analysis we assessed the following: duration of the operation, incidence of the postoperative com-plications, length of hospitalization, quality of patient’s life and pain syndrome severity.
Results. Comparative analysis of the operative results after Beger’s operation in the modification of the clinic and the Berne variant of Beger’s operation showed the lack of reliable differences in such parameters as duration of the operation, volume of intraoperative hemotransfusion and length of the in-patient treatment. Statistically significant improvement of the parameters of the life quality was registered after Beger’s operation in the modification of the clinic if compared with the preo-perative period in the following parameters: physical functioning, pain severity, role functioning conditioned by the physical state, life activity, general health, social functioning, psychic health and pain level value according to VAS.
Conclusions. The results of the prospective research prove that duodenum-saving resection of the pancreas head permits to achieve high professional rehabilitation in patients with chronic pancreatitis in the distant postoperative period. Duodenum-saving operations improve the quality of life in the postoperative period due to elimination of pain and obstructive complications of chronic pancreatitis and they are comparable with each other in the distant results. Beger’s operation in the modification of the clinic is more preferable in case of large size of the pancreas head and if pseudo aneurism and portal hypertension are present.

Keywords: chronic pancreatitis, Beger’s operation, the Berne variant, complications, quality of life
p. 38 - 48 of the original issue
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Address for correspondence:
210023, Respublika Belarus, g. Vitebsk, pr. Frunze, d. 27, UO «Vitebskiy gosudarstvennyiy meditsinskiy universitet», kafedra khirurgii FPK i PK,
e-mail: anatol1961@bk.ru,
Schastnyiy Anatoliy Tadeushevic
Information about the authors:
Shastny A.T. Candidate of Medical Sciences, Associate Professor of the Surgery Chair of the Faculty of Advaned Training and Staff Retraining of EE “Vitebsk State Medical University”.
Matevossian E. Privat docent, MD, Department of Surgery and Transplantation Clinic "Rehts der Isar" of the Technical University of Munich.
Doll D. Privat docent, MD, Department of Visceral, Vascular and Thoracic Surgery, Philipps-University of Marburg.
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