Contemporaneous Therapeutic Strategies in Chronic Pancreatitis and it's Complications
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HOTINEANU, Vladimir, CAZAC, Anatol, HOTINEANU, Adrian, IVANCOV, Grigore, COTONEŢ, Alexei, PRIPA, Valeriu. Contemporaneous Therapeutic Strategies in Chronic Pancreatitis and it's Complications. In: Hepato-Gastroenterology, 2013, nr. 60(126,S.), pp. 86-87. ISSN 0172-6390.
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Hepato-Gastroenterology
Numărul 60(126,S.) / 2013 / ISSN 0172-6390

Contemporaneous Therapeutic Strategies in Chronic Pancreatitis and it's Complications


Pag. 86-87

Hotineanu Vladimir, Cazac Anatol, Hotineanu Adrian, Ivancov Grigore, Cotoneţ Alexei, Pripa Valeriu
 
Timofei Moșneaga Republican Clinical Hospital
 
Disponibil în IBN: 14 ianuarie 2022


Rezumat

Introduction: Global incidence of chronical pancreatitis (CP) and it`s complications in continuous growing, involvement of etiopathogenic various mechanisms in its evolution, required involvement of the numerous surgical gestures place this pathology into the category of high risk. Materials and Methods: This study represents the results of surgical treatment applied on 423 patients suffering of CP and it's complications, held in 1992-2012 period at Surgical Clinic No. 2. The elective operations included pancreaticojejunal anastomose on the Roux hook (PJA) - 108 (32,7%) cases; thoracoscopic splanhnicectomia - 25 (26,13%) cases; cephalic duodenopancreatectomy - 3 (0,5%) cases. In the more complicated cases with pancreatic pseudocyst (PP) - cystpancreaticojejunal anastomose (CPJA) on the Roux hook-154 (47,61%) cases, external drainage of the PP-60 (5,04%) cases, echo-guided punction of the PP-7 (2,22%) cases. For the cases of the complicated CP with mechanical jaundice-PJA with colecisto- or coledoco-jejunal anastomose on the bispiculated hook a la Roux -7 (1,59%) cases, CPJA with colecisto- or coledoco-jejunal anastomose on the bispiculated hook a la Roux-27 (7,94%) cases and colecisto- (coledoco-) jejunal anastomose on the Roux hook-32 (34,09%) cases. Results and Interpretations: In all operated patients the perioperative mortality and morbidity was 0. A favorable evolution was observed in 337 (83,7%) cases. The early complication rate constituted 3 (9,3%) cases of all patients. Late complications occurred in 20 (4,4%) cases requiring classical surgical intervention for 11 (2,72%) cases and minimally invasive intervention for 10 (2,72%) patients. Conclusions: The surgical treatment of CP and it’s complications depend on the parenchymal changes and Wirsung duct sizes and includes a wide range of surgical procedures from internal or external serial recovery til resections with primary reconstruction of the digestive tract continuity, contributes to life quality improvement and reduces the frequency of postoperative complications.

Cuvinte-cheie
cronical pancreatitis, surgical treatment, complications