Assessment of the structural and functional statе of the pancreas in different groups of patients with chronic biliary pancreatitis
DOI:
https://doi.org/10.11603/2414-4533.2020.2.10768Keywords:
chronic pancreatitis, biliary genesis, cholecystectomy, pancreas, structural conditionAbstract
The aim of the work: assessment of the structural and functional status of the pancreas in different groups of patients with chronic biliary pancreatitis on conservative management and after surgical intervention.
Materials and Methods. 115 patients with chronic biliary pancreatitis were divided into 4 groups. Group 1 (26 patients) included patients with CP combined with functional disorders (FD) of the biliary system. Group 2 (30 patients) consisted of patients with CP in combination with not-stone chronic cholecystitis (NCC). Group 3 (34 patients) included patients with CP after laparotomy cholecystectomy (LTCE). Group 4 (25 patients) included patients with CP after minimally invasive cholecystectomy (MICE).
Age of patients – from 30 to 71 years. Patients were comparable in age, sex, and disease duration to (10.0±1.5) years. External secretory function of the pancreas was evaluated using fecal α-elastase, which was determined by the method of enzyme-linked immunosorbent assay, and the index of coprogram expressed in points. Evaluation of the condition and structure of the pancreas was performed by the elastography of the shear wave with the scanning ultrasound equipment Ultima PA.
Results and Discussion. Indicators of the extracellular function of the pancreas worsened with the deepening of the pathological process in the hepatobiliary system. There was a marked excretory insufficiency in both studied parameters.
The results proved that the most damaged structure of the pancreas was in the CP+LTCE group of patients, and the lowest indicators of stiffness were observed in the CP+MICE group.
The following rating of influence of etiologic biliary factor on the structural and functional state of the pancreas towards reducing the level of rigidity and improving its excretory function was established: laparotomic cholecystectomy> non-calculous cholecystitis = functional disorders of hepatocellular system.
References
Babinets, L.S., & Nazarchuk, N.V. (2014). Patohenetychni aspekty khronichnoho pankreatytu biliarnoho henezu pislia kholetsystektomii [Pathogenetic aspects of chronic pancreatitis of biliary genesis after cholecystectomy]. Vestnyk kluba pankreatologov – Journal of the Pancreatology Club, 3 (24), 4-8 [in Ukrainian].
Zvyagintseva, T.D., & Shargorod, I.I. (2012). PKhES: disfunktsiya sfinktera Oddi [PCAC]. Liky Ukrainy – Medicines of Ukraine, 2 (148), 100-106 [in Russian].
Gubergrits, N.B., Belyayeva, N.V., Klochkov, A.Ye., Suprun, A.A., & Fomenko, P.G. (2018). Mesto ingibitorov protonnoy pompy v lechenii khronicheskogo pankreatita. Obzor i sobstvennye nablyudeniya [Place of proton pump inhibitors in the treatment of chronic pancreatitis. Review and own observations]. Suchasna hastroenterolohiia – Modern Gastroenterology, 4, 85-94 [in Ukrainian].
Nakaz MOZ Ukrainy vid 10.09.2014 № 638. Unifikovanyi klinichnyy protokol pervynnoi, vtorynnoi (spetsializovanoi) medychnoi dopomohy ta medychnoi reabilitatsii. Khronichnyi pankreatyt [Order of the MHU No. 638 dated September 10, 2014. Unified clinical protocol of primary, secondary (specialized) medical care and medical rehabilitation. Chronic Pancreatitis]. Kyiv [in Ukrainian].
Gubergrits, N.B., Belyayeva, N.V., Lukashevich, G.M., Klochkov, A.Ye., Fomenko, P.G., Yaroshenko, L.A., …, & Rakhmetova, V.S. (2019). Novosti Yevropeyskoy pankreatologii (po materialam 50-y vstreche Yevropeyskogo Kluba Pankreatologov) [News of European Pancreatology (based on the materials of the 50th meeting of the European Club of Pancreatologists)]. Vestnik kluba pankreatologov – Bulletin of the Pancreatologists Club, 4 (41), 4-15 [in Russian].
Selezneva, Ye.Ya. (2019). Korrektsiya funktsionalnogo biliarnogo rasstroystva – realnaya proffilaktika kholelitiaza [Correction of functional biliary disorder – a real prevention of cholelithiasis]. Farmateka – Farmateca, 2, 93-96 [in Russian].
Solovyeva, G.A. (2015). Diagnoz khronicheskogo pankreatita: istinnyye kriterii [The diagnosis of chronic pancreatitis: true criteria]. Mystetstvo likuvannia – The Art of Healing, 5-6, 54-56 [in Russian].
Solomentseva, T.A. (2018). Rekomendatsii Obiednanoi yevropeiskoi hastroenterolohichnoi asotsiatsii z diahnostyky ta likuvannia khronichnoho pankreatytu [Recommendations of the United European Gastroenterology Association for the diagnosis and treatment of chronic pancreatitis]. Suchasna hastroenterolohiia – Modern Gastroenterology, 3, 78-93 [in Ukrainian].
Stepanov, Yu.M., & Zaichenko, N.H. (2012). Khronichnyi pankreatyt: biliarnyi mekhanizm, chynnyky ta perebih [Chronic pancreatitis: biliary mechanism, factors and course]. Zaporozhskiy medytsynskiy zhurnal – Zaporozhye Medical Journal, 1 (70), 46-50 [in Ukrainian].
Gubergrits, N.B., Lukashevich, G.M., Golubova, O.A., & Fomenko, P.G. (2013). Kholetsistektomiya i sfinkter Oddi: kak dostignut konsensusa? [Cholecystectomy and sphincter of Oddi: how to reach consensus?]. Suchasna hastroenterolohiia – Modern Gastroenterology, 1, 55-65 [in Ukrainian].
Khrystych, T.N., & Hontsariuk, D.A. (2018). Etiolohichni faktory, shcho formuiut khronichnyi pankreatyt [Etiological factors which form the chronical pancreatitis]. Zdobutky klinichnoi i eksperymentalnoi medytsyny – Achievements of Clinical and Experimental Medicine, 3, 20-28 [in Ukrainian].
Machicadoetal, J.D. (2018). A population-based evaluation of the natural history of chronic pancreatitis. Pancreatology, 18, 1, 39-45. DOI: https://doi.org/10.1016/j.pan.2017.11.012
Byelyayeva, N.V. (2016). Treatment of chronic biliary pancreatitis in patients with obesity. Pancreatology, 16, 1, S6-S4. DOI: https://doi.org/10.1016/j.pan.2015.12.016
Rodriguesetal, E. (2019). Clube Portugues do pancreas recommendations for chronic pancreatitis: Etiology, natural history, and diagnosis (Part 1). Portugese Journal of Gastroenterology, 26, 346-355. DOI: https://doi.org/10.1159/000497388
Di Magno, E.P., & Di Magno, M.J. (2016). Chronic pancreatitis: land mark papers, management decisions, and future. Pancreas, 45, 5, 641-650.
Imm, N. (2016). Gall stones and Cholecystitis. Retrieved from: https://patient.info/doctor/gallstones–and–cholecystitis.
Babinets, L., Kytsai, K., Kotsaba, Yu., Halabitska, I., Melnyk, N., Semenova, I., & Zemlyak, O. (2017). Improvement of the complex medical treatment for the patients with chronic biliary pancreatitis. Wiedomosti Lekarskie, 2 (1), 213-216.
Dominguez-Munoz, J.E., Drewes, A.M., Lindkvist, B., Ewald, N., Czakó, L., Rosendahl, J., & Löhr, J.M. (2018). Recommendations from the United European Gastroenterology evidence-based guidelines for the diagnosis and therapy of chronic pancreatitis. Pancreatology, 18, 8, 847-854. DOI: https://doi.org/10.1016/j.pan.2018.09.016
Turumin, J.L. Postcholecystectomy syndrome, or condition after cholecystectomy (gallblader removal). Retrieved from: http://www.drturumin.com.
Downloads
Published
How to Cite
Issue
Section
License
Authors who publish their work in Hospital Surgery. Journal by L. Ya. Kovalchuk agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access)
