106 patients with chronic pancreatitis (CP) underwent surgery at the department of surgery of the Ivano-Frankivsk Regional Clinical Hospital during 2009-2014, including 97 (90.5 %) men and 9 (9.5 %) women. Six of these patients had had previous CP surgeries (2 patients had had longitudinal pancreatico-jejunostomy, 3 – endoscopic interventions in extrahepatic biliary tract, and 1 – endoscopic stenting of Wirsung’s duct). However, due to progressive fibrous degenerative changes in pancreatic tissue they required a repeated surgery. Different complications of CP were found in 39 (36.7 %) patients: biliary hypertension (BH) in 26 (24.5 %) patients, chronic duodenal obstruction (CDO) in 10 (9.4 %) patients, combination of CDO and BH and local venous hypertension of pancreatico-biliary area – 4 (3.8 %) patients. Before the operation, diabetes mellitus had been diagnosed in 11(10.4%) patients.
Proximal resection surgeries on pancreatic head were applied in 27 (25.5%) cases, among them: 4 patients underwent pancreatico-duodenal resection, 23 patients – duodenum preserving procedures (including 2 cases according to Beger in Berne modification, and 21 Frey’s procedures). Berne procedure was conducted in 2 male patients 34 and 44 years old. Frey’s procedure was used in 21 cases: 20 male and 1 female patient. Average age of patients is 44±6.6. Four patients (three men and one woman 45.3±8.4 years old) underwent pancreaticoduodenal resection. Two out of 27 patients died (postoperative mortality comprised 7.4%).
Proximal resection procedures on pancreatic head are pathogenetically reasoned in cases of fibrous-degenerative forms of chronic pancreatitis, and allow to eliminate pain syndrome and malfunction of adjacent organs. A significant number of postoperative complications of pancreatic resection surgeries is connected primarily with the injury of pancreatic tissue, and requires less traumatic surgery techniques following specific indications.
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