Abstract:
Background: The main radical surgical treatment of patients with focal lesions of the pancreatoduodenal zone, accompanied by
obstructive jaundice, is pancreatoduodenal resection.
Aim of the study: To improve the results of radical surgical treatment of patients with focal lesions of the pancreatobiliary zone,
complicated by obstructive jaundice.
Methods and materials: The results of radical surgical treatment of 272 patients were analyzed. Cancer of the head of the pancreas
was verified in 174 (63.9%) of patients, Vater's papilla cancer - in 20 (7.4%), distal choledochal cancer - in 24 (8.8%) and chronic
pseudotumoral pancreatitis - in 54 (19, 9%) patients.
Results: In each patient the magnitude of the planned operation risk was determined according to the own formula (taking into
account the main pathological parameters of the patient’s condition). If the value of the prognostic risk factor for pancreatoduodenal
resection performing exceeded the allowable limit (≥ 60), biliary decompression was performed. During pancreatoduodenal resection, a
Whipple termino-lateral anastomosis was applied in 38 (13.9%) patients, termino-terminal in 40 (14.7%) cases, pancreatojejunostomy
ductomucosal anastomosis - in 128 (47.1 %) cases, pancreatogastrostomy - in 35 (12.9%) cases, sleeve pancreatogastrostomy - in
31 (11.4%) cases. The most frequent complication after PD was the failure of pancreatoenteroanastomosis (type A-B according to
ISGPF) - 32 (11.2%). 14 patients died. Mortality rate was 5.1%.
Description:
Odessa National Medical University, Odessa, Ukraine, Al XIII-lea Congres al Asociației Chirurgilor „Nicolae Anestiadi” și al III-lea Congres al Societății de Endoscopie, Chirurgie miniminvazivă și Ultrasonografie ”V.M.Guțu” din Republica Moldova