POSSIBLE SURGERIES ON BILE DUCTS IN CASES OF CHRONIC PANCREATITIS WITH SIGNS OF BILIARY HYPERTENSION
DOI:
https://doi.org/10.11603/2414-4533.2016.2.6406Abstract
We analyzed the results of surgical treatment of 46 patients with chronic pancreatitis (CP) complicated by biliary hypertension
(BH). Intraoperative monitoring of biliary pressure (IOM BP) to diagnose BH was applied during the duodenum-preserving
resections of the pancreas in 16 patients. Frey’s procedure was applied in 18 (39.1 %) patients with CP complicated by BH. In
6 (10.8 %) patients, BH was eliminated using the standard Frey’s procedure, in 12 (21.6 %) patients the Frey’s procedure was
supplemented by interventions on bile ducts. Beger’s procedure (Berne modifi cation) was applied in two (4.3 %) patients with
CP complicated by BH, hepaticojejunostomy was not used. Pancreaticoduodenal resection (PDR) (the Whipple procedure)
was applied in 5 (10.8 %) patients with CP complicated by BH. Surgeries on bile ducts for correction of BH were done in
the following modifi cations: Frey’s procedure with internal biliopancreatic junction (BPJ) was applied in one patient; the
method of pancreatoenteroduodenoanastomosis according to V. M. Kopchak with Roux-en-Y hepaticojejunostomy was used
in 8 patients; hepaticojejunostomy and Roux-en-Y anastomosis were applied in 8 patients; in 3 patients, panreaticoentero- and
hepaticojejunostomy were applied successively on one loop according to Roux. No complications were witnessed in the early
postoperative period. Remote results of surgical treatment, which were traced in 33 (71.7 %) patients, were estimated as good
and satisfactory, there were no signs of BH in the remote postoperative periods.
References
Ярешко В. Г. Выбор метода хирургического лечения хро-
нического панкреатита и его осложнений / В. Г. Ярешко,
Ю. А. Михеев // XXIII з’їзд хірургів України : зб. наукових
робіт. – К., 2015. – С. 219–220.
Желчная гипертензия у больных хроническим панкреатитом /
С. Д. Добров, А. С. Полякевич, Е. М. Благитко, Г. Н. Толстых //
Анналы хирургической гепатологии. – 2012. – № 4. – С. 35.
Büchler M. W. Duodenum preserving resection of the head
of the pancreas: a standard procedure in chronic pancreatitis
/ M. W. Büchler, H. U. Baer, C. Seiler // Chirurgie. – 1997. –
Vol. 68 (4). – P. 364–368.
Sebastiano P. di. Pathophysiology of Chronic Damage / P. di
Sebastiano, F. F. di Mola // Acute and Chronic Pancreatitis: New
concepts and evidence-based approaches / ed. By P. A. Testoni,
A. Mariani, P. G. Arcidiacono. – Turin : Edizioni Minerva Medica,
– P. 63–69.
Хирургическая анатомия поджелудочной железы /
В. М. Копчак, А. Ю. Усенко, К. В. Копчак, А. И. Зелинский. –
К. : Издательский дом “Аскания”, 2011. – 141 с.
Отдаленные результаты изолированной резекции го-
ловки поджелудочной железы с декомпрессией панкре-
атических протоков у больных хроническим панкреати-
том / Э. И. Гальперин, Т. Г. Дюжева, И. А. Семененко [и
др.] : материалы Пленума Правления Ассоциации хирургов-
гепатологов России и стран СНГ (19–20 апреля 2012 года). –
Ижевск. – С. 13–15.
Резолюция Пленума Правления Ассоциации хирургов-
гепатологов России и стран СНГ (Ижевск, 19–20 апреля
г.) “Хронический панкреатит” // Анналы хирургической
гепатологии. – 2012. – Т. 17, № 3. – С. 118–119.
Билиарная гипертензия при хроническом панкреатите /
А. В. Воробей, А. Ч. Шулейко, Ю. Н. Орловский [и др.] //
Новости хирургии. – 2014. – № 4. – С. 408–441.
Пат. 101713 Україна, МПК А 61В 17/00. Спосіб хірур-
гічного лікування хронічного панкреатиту, ускладнено-
го жовчнокам’яною хворобою / В. І. Пилипчук, В. М. Коп-
чак, І. М. Шевчук. – № u 2015 03315; заявл. 09.04.2015;
опубл. 25.09.2015, Бюл № 18.
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)
