Novosti
|
This journal is indexed in Scopus |
---|
Year 2015 Vol. 23 No 2
GENERAL AND SPECIAL SURGERY
I.A. KRIVORUCHKO, I.A. TARABAN, I.V. SOROKINA, N.N. GONCHAROVA
MORPHOLOGICAL FEATURES OF CAVITARY FORMATIONS IN ACUTE PANCREATITIS
Kharkov National Medical University of the MH of Ukraine
Ukraine
Objectives. To study the features of the morphological structure of the wall of cavitary formations in acute destructive pancreatitis at different stages of development using immunohistochemical methods.
Methods. The features of the wall microstructure of cavitary formations and adjacent pancreatic parenchyma have been studied on the biopsied material (81 cases) depending on the morphology of the connective tissue component using histological, histochemical and immunohistochemical methods.
Results. It was established that in patients both as with complicated and not complicated delimited pancreatic necrosis foci at the morphological study a similar pattern has been observed. The wall of formation and glandular interstice were presented by a loose fibrous connective tissue with primary predominance of cellular elements and small volume of fibers, thus both focal (non-complicated course), and diffuse (complicated one) inflammatory infiltration of the formation wall was registered. The presence of dense connective tissue, the localization of the inflammatory infiltrate in the inner layers of the wall, prevalence of type I collagen in the capsule of pseudocysts as well as cells producing IL-2 and IL-6 testified to the reduction of the inflammatory process activity. Loose connective tissue, diffuse inflammatory infiltration in all layers of the wall, the predominance of type III collagen and reduction of the number of cells producing IL-2 and IL-6 manifested the inflammatory activity retention. Taking into account the commonality of morphological changes in patients with complicated pseudocysts and delimited foci of pancreatic necrosis, all forms of cavitary formations were considered as initially unfavorable course of the pathological process, requiring surgical correction.
Conclusion. Growth factors and cytokines are thought to be the triggers of the pancreatic fibrogenesis. IL-2 and IL-6 promote the intracellular matrix synthesis rich of collagen type I and III, thus promoting fibrosis in pancreatitis. It was established that in pancreatitis not only the content synthesis of the extracellular matrix is increased, but also its degradation is inhibited by reducing the specific activity of metalloenzymes.
- Vinokurov MM, Savel'ev VV, Ammosov VG. Khirurgicheskie vmeshatel'stva pri infitsirovannykh formakh pankreonekroza [Surgery for infected pancreatic necrosis forms]. Khirurgiia: Zhurn im NI Pirogova. Moscow, RF: Media Sfera. 2009;(11):23-26.
- Da Costa DW, Boerma D, van Santvoort HC, Horvath KD, Werner J, Carter CR, Bollen TL, Gooszen HG, Besselink MG, Bakker OJ. Staged multidisciplinary step-up management for necrotizing pancreatitis. Br J Surg. 2014 Jan;101(1):e65-79. doi: 10.1002/bjs.9346.
- Huber W, Schmid RM. Diagnosis and treatment of acute pancreatitis. Current recommendations Internist (Berl). 2011 Jul;52(7):823-30, 832. doi: 10.1007/s00108-010-2796-x. [Article in German].
- Tenner S, Baillie J, DeWitt J, Vege SS. American College of Gastroenterology American College of Gastroenterology guideline: management of acute pancreatitis. Am J Gastroenterol. 2013 Sep;108(9):1400-15; 1416. doi: 10.1038/ajg.2013.218.
- Kondratenko PG, Vasil'ev AA, Kon'kova MV. Ostryi pankreatit [Acute pancreatitis]. Donetsk, Ukraina: 2008. 352 p.
- Nechitailo ME, Snopok IuV, Bulik II. Kisty i kistoznye opukholi podzheludochnoi zhelezy [Cysts and cystic tumors of the pancreas]. Kiev, Ukraina: Poligrafkniga. 2012. 544 p.
- Dumonceau JM, Andriulli A, Deviere J, Mariani A, Rigaux J, Baron TH, Testoni PA. European Society of Gastrointestinal Endoscopy.European Society of Gastrointestinal Endoscopy (ESGE) Guideline: prophylaxis of post-ERCP pancreatitis. Endoscopy. 2010 Jun;42(6):503-15. doi: 10.1055/s-0029-1244208.
- Hut'an M, Rashidi Y, Novák S, Hut'an M Jr. [How long to wait with operations for necrotizing pancreatitis?]. [Article in Slovak] Rozhl Chir. 2010 Aug;89(8):513-17.
- Banks PA, Bollen TL, Dervenis C, Gooszen HG, Johnson CD, Sarr MG, Tsiotos GG, Vege SS; Acute Pancreatitis Classification Working Group. Classification of acute pancreatitis--2012: revision of the Atlanta classification and definitions by international consensus. Gut. 2013 Jan;62(1):102-11. doi: 10.1136/gutjnl-2012-302779.
- Ojo EO, Babayo UD.Pancreatic pseudocyst in Federal Medical Centre, Gombe and review of literature. Niger J Med. 2010 Apr-Jun;19(2):223-29.
- Kopchak VM, Kopchak KV, Khomiak ²V, Duvalko OV, Pererva LO. Tereshkevich ²S, Moshk³vs'kii GIu, Kondratiuk VA. Suchasn³ p³dkhodi do l³kuvannia uskladnenikh psevdok³st p³dshlunkovo¿ zalozi [Current approaches to the treatment of complicated pancreatic pseudocyst]. Naukovii V³sn Uzhgorod Un-tu. 2014;1(49):106-10. Available from: http://nbuv.gov.ua/j-pdf/UNUMED_2014_1_27.pdf
- Kon'kova MV, Smirnov NL, Iudin AA. Ul'trazvukovaia diagnostika i diapevtika ostrogo pankreatita [Ultrasound diagnosis and diapevtics of acute pancreatitis]. Donetskii nats med un-tet im M Gor'kogo. Ukr Zhurn Khirurgii 2013;3(22):132-35
61022, Harkov, Ukraina, pr. Lenina, d. 4,
Harkovskiy natsionalnyiy meditsinskiy universitet,
kafedra khirurgii 2,
tel. office 38 050 301-90-90,
e-mail: dr_tia@mail.ru
Taraban Igor Anatolevich
Krivoruchko I.A. MD, professor, a head of the surgery chair ¹2 of Kharkov National Medical University.
Taraban I.A. MD, professor of the surgery chair ¹1 of Kharkov National Medical University.
Sorokina I.V. MD, professor of the pathologic anatomy chair of Kharkov National Medical University.
Goncharova N.N. PhD, doctoral candidate of the surgery chair ¹2 of Kharkov National Medical University.