Pancreatoduodenal resection in the treatment of complicated forms chronic pancreatitis

Abstract

Purposeof thestudy. Development ofindications for performing pancreatoduodenal resection in complicated forms of chronic pancreatitis. Materials and methods. In chronic pancreatitis, resection and drainage surgical interentions were performed in 142 patients. Pancreatoduodenal resection was performed in 13 patients with complicated forms of chronic pancreatitis. To assess the degree of pancreatic fibrosis, ultrasound elastography was used (in mode Shear Wave Elastography). The indications for pancreatoduodenal resection were the presence of a pronounced fibroinflammatory process in the head of the pancreas, the impossibility of excluding the development of an oncological process, developed complications (biliary hypertension, portal hypertension, duodenal stasis, Results. Among 13 patients with complicated forms of chronic pancreatitis, who underwent pancreatoduodenal resection, 12 (92,3%) patients had severe fibrosis, 1 (7,7%) had minor manifestations of fibrosis. Pancreatoduodenal resection was performed in 2 (15,4%) patients after preliminary biliary decompression, in 2 (15,4%) – after Pjustov-Frey surgery and cystojejunostomy. Conclusion. Progression of fibroinflammatory changes in the pancreatic parenchyma in chronic pancreatitis, leading to the development of complications (biliary hypertension, duodenal stasis), is an indication for the use of resection surgery.

Keywords

• complicated forms of chronic pancreatitis
• pancreatoduodenal resection