Scop: analiza rezultatelor tratamentului miniinvaziv și chirurgical (paliativ æi rezecåional) la pacienåii cu tumori pancreatice (TP)
spitalizaåi în urgențã.
Material æi metodã: Studiu retrospectiv, 2014-2019, 185 pacienåi cu TP spitalizaåi în IMU, Chiæinãu, vârsta medie 63,91±10,98 ani,
raportul B:F/1,15:1. Cauza spitalizãrii: icter – 121(65,48%) cazuri, formațiune intraabdominalã - 41(22,16%), abdomen acut –
23(12,43%). Diagnosticul de TP a fost pus la: TC–129(69,73%); RMN–14(7,69%) și/sau CPGRE–102(55,14%), iar într-un caz intraoperator,
operat pentru peritonita. Localizare TP: cefalic – 163(89,56%) cazuri, corporeo-caudal - 22(11,89%). 35(19,23%) pacienåi
au fost refuzat orice procedura terapeuticã. S-au structurat trei loturi: lot.SE – stentare biliarã la CPGRE sau transparietohepatic,
lot.ABD – derivație biliodigestivã, lot.RP – rezecție pacnreaticã.
Rezultate: Lot.SE: 87(47,03%) cazuri, stentaåi endoscopic–79(90,80%), transparietohepatic–8(9,20%), vârsta–65,62±11,65ani,
bilirubinemia–222,0±122,0mmol/l, durata spitalizãrii–10,70±6,42zile, mortalitatea p/op - 9(10,34%). Lot.ABD: 25(13,74%) cazuri,
vârsta–61,2±10,87ani, bilirubinemia–86,0±17,0mmol/l, durata spitalizãrii¬–21,21±10,04zile, inclusiv–ATI–2,3±1,49zile, stentare
preoperatorie–7(28%)cazuri, mortalitatea p/op–4(16,0%). Lot.RP: 38(20,54%) cazuri, duodenopancreatectomie cefalicã –
27(71,05%) æi pancreatectomie distalã cu splenectomie–11(28,94%), vârsta–59,34±8,59ani, bilirubinemia–84,5±13,5mmol/l în TP
cefalice, stentaåi preoperator 8(29,63%) (bilirubinemia 218,5±85,74mmol/l), durata spitalizãrii–29,49±19,52zile, inclusiv
ATI–7,0±3,0zile, mortalitatea p/op-6(16,22%): rezecåie pancreatoduodenalã(5), pancreatectomie distalã(1).
Concluzii: Rata operaåiilor rezecționale cu viza de radicalitate rãmâne a fi sub limitatã mondialã raportatã din cauza adresabilitãåii æi
diagnosticului tardiv. Stentarea biliarã endoscopicã æi derivaåia biliodigestivã sunt cele mai frecvente opåiuni de rezolvare a TP
complicate cu sindrom colestatic. Mortalitatea postoperatorie în lotul ABD æi RP a fost similarã, dar durata spitalizãrii æi rata
complicaåiilor mai mare pentru RP.

Goal: analysis of mini-invasive and surgical (palliative and resectional) treatment results in patients with pancreatic tumours(PTs)
hospitalized in emergency.
Material and method: Retrospective study, 2014-2019, 185 patients with PT hospitalized in Institute of Urgent Care Medicine,
Chisinau, age 63,91±10,98years, M:W ratio 1,15:1. Cause of hospitalization: jaundice – 121(65,48%) cases, intra-abdominal tumour
− 41(22,16%), acute abdomen – 23(12,43%). The diagnosis of PT was established by: CT–129(69,73%); NMR–14(7,69%) and/or
ERCP–102(55,14%), and in one case intraoperative, operation for peritonitis. PT localization: head of pancreas – 163(89,56%)
cases, body or tail − 22(11,89%). 35(19,23%) patients refused any therapeutic procedure. The patients were divided into three
groups: group.ES – biliary stenting through ERCP or transparietohepatic, group.BDD – biliodigestive derivation, group. PR –
pancreatic resection.
Results: Group.ES: 87(47,03%) cases, endoscopic stenting–79(90,80%), transparietohepatic–8(9,20%), age–65,62±11,65years,
serum bilirubin level–222,0±122,0mmol/l, hospitalization time–10,70±6,42days, postoperative mortality−9(10,34%).
Group.BDD: 25(13,74%) cases, age–61,2±10,87years, serum bilirubin level–86,0±17,0mmol/l, hospitalization
time–21,21±10,04days, ICU length of stay–2,3±1,49days, preoperative stenting–7(28%)cases, postoperative mortality–4(16,0%).
Group.PR: 38(20,54%) cases, cephalic duodeno-pancreatectomy–27(71,05%) and distal pancreatectomy with splenectomy–
11(28,94%), age–59,34±8,59years, serum bilirubin level–84,5±13,5mmol/l in pancreatic head tumour, preoperative stenting
8(29,63%) (serum bilirubin level 218,5±85,74mmol/l), hospitalization time–29,49±19,52days, ICU length of stay–7,0±3,0days, postoperative mortality−6(16,22%): pancreaticoduodenal resection(5), distal pancreatectomy(1).
Consclusions: The rate of radical resection surgeries remains to be under global level due to late addressability and diagnosis. Endoscopic
biliary stenting and biliodigestive derivation are the most frequent treatment options for the PT complicated by jaundice. Postoperative
mortality in the groups BDD and PR is similar, but the hospitalization time and complication rate is higher in group PR.