Year 2017 Vol. 25 No 4




FSBEE HE Voronezh State Medical University
named after N.N.Burdenko,
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
  1. Grinevich VB, Maistrenko NA, Priadko SA, Romashchenko PN, Shcherbina NN. Problema khronicheskogo pankreatita s pozitsii terapevta i khirurga [The problem of chronic pancreatitis from the position of a therapist and surgeon]. Med Akad Zhurn. 2011;12(2):35-55
  2. Parkhisenko IuA, Zhdanov AI, Parkhisenko VIu, Kalashnik RS. Khronicheskii kal'kuleznyi pankreatit: obzor podkhodov k khirurgicheskomu lecheniiu [Chronic calculous pancreatitis: an overview of approaches to surgical treatment]. Annaly Khirurg Gepatologii. 2014;19(2):91-98.
  3. BegerHG, BuchlerM, BittnerR, OttingerW, RoscherR. Duodenum-preserving resection of the head of the pancreas in severe chronic pancreatitis. Ann Surg. 1989 Mar;209(3):273-79.
  4. Egorov VI, Vishnevskii VA, Shchastnyi AT, Shevchenko TV, Zhavoronkova OI, Petrov RV, i dr. Rezektsiia golovki podzheludochnoi zhelezy pri khronicheskom pankreatite. Kak delat' i kak nazyvat'? [Resection of the pancreas head in chronic pancreatitis. How to do and how to call?] (analiticheskii obzor). Khirurgiia Zhurn im NI Pirogova. 2009;(8):57-66.
  5. Adamek HE, Jakobs R, Buttmann A, Adamek MU, Schneider AR, Riemann JF. Longtermfollowupofpatients with chronic pancreatitis and pancreatic stones treated with extracorporeal shock wave lithotripsy. Gut. 1999 Sep;45(3):402-5.
  6. Korpela T, Udd M, Tenca A, Lindström O, Halttunen J, Myrskysalo S, еt al. Long-term results of combined ESWL and ERCP treatment of chronic calcific pancreatitis. Scand J Gastroenterol. 2016 Jul;51(7):866-71. doi: 10.3109/00365521.2016.1150502.
  7. Andersen DK, Frey CF. The evolution of the surgical treatment of chronic pancreatitis. Ann Surg. 2010 Jan;251(1):18-32. doi: 10.1097/SLA.0b013e3181ae3471.
  8. Kubyshkin VA, Kozlov IA, Kriger AG, Chzhao AV. Khirurgicheskoe lechenie khronicheskogo pankreatita i ego oslozhnenii [Surgical treatment of chronic pancreatitis and its complications]. Annaly Khirurg Gepatologii. 2012;17(4):24-34.
  9. Klimenko AV, Klimenko VN, Steshenko AA, Tumanskii VA, Kovalenko IS. Khirurgicheskoe lechenie khronicheskogo pankreatita s protokovoi gipertenziei bez protokovoi dilatatsii [Surgical treatment of chronic pancreatitis with ductal hypertension without ductal dilatation]. Ukr Zhurn Khirurgii. 2013;(1):22-27.
  10. Vorobei AV, Shuleiko ACh, Grishin IN, Orlovskii IuN, Il'iushonok VV, Aleksandrov SV, i dr. Ispol'zovanie vysokoenergeticheskogo lazera v gepatopankreatobiliarnoi khirurgii [The use of high-energy laser in hepatopancreatobiliary surgery]. Ukr Zhurn Khirurgii. 2013;(3):63-69.
  11. Iareshko VG, Mikheev IuA. Rezektsionnye i dreniruiushchie operatsii v lechenii khronicheskogo pankreatita i ego oslozhnenii [Resection and drainage operations in the treatment of chronic pancreatitis and its complications]. Ukr Zhurn Khirurgii. 2013;(3):160-165.
  12. Lazebnik LB, Vinokurova LV, Iashina NI, Bystrovskaia EV, Bordin DS, Dubtsova EA, dr. Khronicheskii pankreatit i rak podzheludochnoi zhelezy [Chronic pancreatitis and pancreatic cancer]. Eksperim i Klin Gastroenterologiia. 2012;(7):3-9.
  13. Parkhisenko IA, ZhdanovAI, ParkhisenkoVIu, Kalashnik RS. Sposob khirurgicheskogo lecheniia khronicheskogo kal'kuleznogo pankreatita [The method of surgical treatment of chronic calculous pancreatitis]. Patent RF A61B17/00; № 2580197. 10.04.2016
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,
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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