Novosti
Khirurgii
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Year 2017 Vol. 25 No 4

GENERAL & SPECIAL SURGERY

DOI: https://dx.doi.org/10.18484/2305-0047.2017.4.340   |  

KALASHNIK R.S., PARHISENKO Y.A.

CHOICE OF SURGICAL TREATMENT METHOD OF CHRONIC CALCULOUS PANCREATITIS

FSBEE HE Voronezh State Medical University
named after N.N.Burdenko,
Voronezh,
The Russian Federation

Objectives. The substantiation of expediency of operative methods and manuals, used in surgical treatment of chronic calculous pancreatitis, on the basis of an estimation of pathological changes of pancreatic parenchyma and pancreatic duct system.
Methods. 42 patients were involved in this study. Operative interventions were carried out in the period from January, 2011 up to March, 2016.Three main and one control group consisting of the patients (n=13) after Roux-en-Y longitudinal pancreaticojejunostomy (operation of Partington-Rochelle) were allocated. In the main groups the following patients were included: the 1st group after cutting-draining operations (n=10), the 2nd after Roux-en-Y longitudinal pancreaticojejunostomy and biliodigestive anastomosis (n=12), the 3rd after resections such as pancreatoduodenectomy, resection of the pancreas body and distal resection of the pancreas (n=7). Incidence and features of postoperative complications, hospital stay length, the quality of patients life and intensity of abdominal pain syndrome were assessed in conducting the comparative analysis.
Results. No lethal outcomes observed. The smallest number of postoperative complications and indicators of the best quality of life on all scales of the international questionnaire MOS SF-36 and all indicators of the questionnaire for postoperative patients with chronic calculous pancreatitis developed by the authors are marked in the main 1st group. Statistically significant improvement of the total values of the parameters of the quality of patients life was received after our the modification of Freys procedure in comparison with the total value of the parameters of the quality of patients life after Freys and Izbickis operations.
Conclusion. The preferential treatment is recommended in the surgery of chronic calculous pancreatitis based on pathological calculous changes of pancreatic parenchyma and pancreatic duct system. The application of a method (developed by the authors) of ultrasonic selective dissection of the pancreatic parenchyma around the pancreatolithes with subsequent removal of latter, significantly improved the treatment results of patients with chronic calculous pancreatitis.

Keywords: chronic calculous pancreatitis, longitudinal pancreaticojejunostomy, Freys procedure, ultrasonic selective dissection of the pancreas parenchyma with removing pancreatolithes, pathological calculous changes of the pancreas, morbidity, mortality
p. 340-349 of the original issue
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Address for correspondence:
394066, Russian Federation,
Voronezh Region,
Voronezh, Moscow Pr., 151,
FSBEE HE "Voronezh State
Medical University. N.N. Burdenko,
Department of Hospital Surgery,
Tel.: +7 (473) 257-97-17,
E-mail: rsk3589@mail.ru,
Roman S. Kalashnik
Information about the authors:
Kalashnik R.S. Post-graduate student of department of the hospital surgery, FSBEE HE Voronezh State Medical University named after N.N.Burdenko.
Parhisenko Y.A. MD, Professor of departmet of the hospital surgery, FSBEE HE Voronezh State Medical University named after N.N.Burdenko.
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