Analysis of the results of surgical procedures advisable for chronic pancreatitis with the isolated lesion of the pancreatic head
https://doi.org/10.31146/1682-8658-ecg-182-10-129-132
Abstract
Recently, studies comparing various variants of operations to establish the optimal method of surgical treatment or chronic pancreatitis with pancreatic head lesions from the point of view of evidence-based medicine have been carried out in the world. However, these comparative studies do not take into account diff erences in the clinical and morphological forms of the disease, in particular, chronic pancreatitis with a predominant and isolated lesion of the head.
Thus, performing a subtotal resection of the pancreatic head with longitudinal pancreatojejunoanastomosis or Frey surgery, which is advisable for chronic pancreatitis with predominant head lesion, in case of an isolated lesion of the head will be an excess of the volume of surgical intervention due to the fact that the outfl ow of secretion along the main pancreatic duct of the distal part of the gland does not disturb, the parenchyma of this part of the body practically does not participate in the pathological process and is changed minimally, and can respond to such an operation with pancreatic necrosis.
Based on the studies performed, it is impossible to say with certainty about the reliable advantages of one type of operations on another.
To obtain reliable results, it’s necessary to conduct evidence-based studies comparing subtotal resection of the pancreatic head with longitudinal pancreatojejunostomy with other types of interventions o nly for chronic pancreatitis with a isolated head lesion, excluding from the study patients with chronic pancreatitis with predominant head lesion.
Thus, performing a subtotal resection of the pancreatic head with longitudinal pancreatojejunoanastomosis or Frey surgery, which is advisable for chronic pancreatitis with predominant head lesion, in case of an isolated lesion of the head will be an excess of the volume of surgical intervention due to the fact that the outfl ow of secretion along the main pancreatic duct of the distal part of the gland does not disturb, the parenchyma of this part of the body practically does not participate in the pathological process and is changed minimally, and can respond to such an operation with pancreatic necrosis.
Based on the studies performed, it is impossible to say with certainty about the reliable advantages of one type of operations on another.
To obtain reliable results, it’s necessary to conduct evidence-based studies comparing subtotal resection of the pancreatic head with longitudinal pancreatojejunostomy with other types of interventions o nly for chronic pancreatitis with a isolated head lesion, excluding from the study patients with chronic pancreatitis with predominant head lesion.
About the Authors
A. S. Polyakevich
Federal State Budget Educational Institution of Higher Education “Novosibirsk State Medical University” Ministry of Health of the Russian Federation
Russian Federation
Russian Federation
Doctor of Medical Sciences, Associate Professor of the Department of Hospital and Pediatric Surgery
630091, Novosibirsk, Krasnyj prospect, 52
E. M. Blagitko
Federal State Budget Educational Institution of Higher Education “Novosibirsk State Medical University” Ministry of Health of the Russian Federation
Russian Federation
Russian Federation
Doctor of Medical Sciences, Professor of the Department of Hospital and Pediatric Surgery
630091, Novosibirsk, Krasnyj prospect, 52
S. D. Dobrov
State Novosibirsk Regional Clinical Hospital
Russian Federation
Russian Federation
Doctor of Medical Sciences, Surgeon of the Surgical Department
630087, Novosibirsk, st. Nemirovich-Danchenko, 130
G. N. Tolstykh
State Novosibirsk Regional Clinical Hospital
Russian Federation
Russian Federation
Candidate of Medical Sciences, Head of the Surgical Department
630087, Novosibirsk, st. Nemirovich-Danchenko, 130
Yu. V. Chikinev
Federal State Budget Educational Institution of Higher Education “Novosibirsk State Medical University” Ministry of Health of the Russian Federation
Russian Federation
Russian Federation
Doctor of Medical Sciences, Head of the Department of Hospital and Pediatric Surgery
630091, Novosibirsk, Krasnyj prospect, 52
E. A. Drobyazgin
State Novosibirsk Regional Clinical Hospital
Russian Federation
Russian Federation
Doctor of Medical Sciences, Head of the Endoscopy Department
630087, Novosibirsk, st. Nemirovich-Danchenko, 130
I. V. Peshkova
Federal State Budget Educational Institution of Higher Education “Novosibirsk State Medical University” Ministry of Health of the Russian Federation
Russian Federation
Russian Federation
Doctor of Medical Sciences, Associate Professor of the Department of Anesthesiology and Intensive Care named after Professor I. P. Vereshchagin
630091, Novosibirsk, Krasnyj prospect, 52
V. A. Egorov
Limited Liability Company “Author's Clinic of Doctor Egorov”
Russian Federation
Russian Federation
Doctor of Medical Sciences, Plastic Surgeon
630123, Novosibirsk, st. 1905 Year, 85/2
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For citations:
Polyakevich A.S., Blagitko E.M., Dobrov S.D., Tolstykh G.N., Chikinev Yu.V., Drobyazgin E.A., Peshkova I.V., Egorov V.A. Analysis of the results of surgical procedures advisable for chronic pancreatitis with the isolated lesion of the pancreatic head. Experimental and Clinical Gastroenterology. 2020;(10):129-132. (In Russ.) https://doi.org/10.31146/1682-8658-ecg-182-10-129-132
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