PECULIARITIES OF PATHOMORPHOLOGICAL STUDIES IN PATIENTS WITH MALIGNANT NEOPLASMS OF THE PANCREATODUODENAL ZONE COMPLICATED BY THE SYNDROME OF MECHANICAL JAUNDICE
DOI:
https://doi.org/10.11603/2414-4533.2025.2.15379Keywords:
diagnostics, histological method, immunohistochemical method, pancreas, adenocarcinoma, pancreaticoduodenal resection, margins of excision, mechanical jaundiceAbstract
The aim of the work: to analyze the possibilities of the modern morphological method of research in the verification and prediction of the course of malignant neoplasms of the pancreatobiliary zone.
Materials and Methods. The study was based on the analysis of the results of surgical treatment of 101 patients with malignant neoplasms of the pancreatobiliary zone, complicated by mechanical jaundice syndrome, who underwent radical surgical intervention in the scope of pancreatoduodenal resection.
Results. The morphological method of the study combined histological and immunohistochemical studies. The initial stage of the morphological study was the correct orientation of the resected and not yet fixed in formalin solution pancreaticoduodenal complex with the determination of all surfaces of the pancreas (P). The wall of the duodenum (DUP) was opened longitudinally through the antipancreatic rib. The condition of the major papilla and the mucosa of the DUP was assessed. The edges of the surgical resection of the common hepatic duct and the pancreatic stump were taken for microscopic examination; the posterior, medial and anterior surfaces of the gland were marked, which helped to assess the R-status during histological examination. It was shown that morphological verification of the type and subtype of the tumor, as well as precursors of ductal adenocarcinoma, was carried out using routine histological examination.
Conclusions. The resection margin is mandatory for the study. Microscopic examination should include a descriptive part indicating the type, nature of growth and structure of the tumor for further determination of the degree of differentiation. The diagnosis should also be made taking into account the expression of Ki67 according to the results of immunohistochemical examination.
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