[Long-term outcomes of pancreatic head resection in chronic pancreatitis].

Autor: Zakharova MA; Vishnevsky National Medical Research Center of Surgery, Moscow, Russia., Kriger AG; Vishnevsky National Medical Research Center of Surgery, Moscow, Russia.; Russian Medical Academy of Continuous Professional Education, Moscow, Russia., Karmazanovsky GG; Vishnevsky National Medical Research Center of Surgery, Moscow, Russia.; Pirogov Russian National Research Medical University, Moscow, Russia., Kondratyev EV; Vishnevsky National Medical Research Center of Surgery, Moscow, Russia., Galchina YS; Vishnevsky National Medical Research Center of Surgery, Moscow, Russia.
Jazyk: ruština
Zdroj: Khirurgiia [Khirurgiia (Mosk)] 2021 (1), pp. 47-54.
DOI: 10.17116/hirurgia202101147
Abstrakt: Objective: To analyze the effect of timing of surgery, quality of resection and removal of MPD-stones on long-term results of duodenum-preserving pancreatic head resection (DPPHR).
Material and Methods: The study included 110 patients with chronic pancreatitis (CP) who underwent DPPHR in 2014-2019. Evaluation of long-term outcomes included pain syndrome severity, exocrine and endocrine insufficiency and quality of life (QoL). Patients were stratified depending on duration of disease (within 36 months, >36 months after manifestation), volume of resected pancreatic head tissue according to CT data, removal of MPD-stones.
Results: Surgical treatment within 36 months after clinical manifestation was followed by less pain syndrome (VAS score 1.16±1.76 vs. 2.03±1.87, p =0.02), exocrine insufficiency (69.8% vs. 98.5%, p <0.001). Resection of more than 50% of the pancreatic head and removal of MPD-stones were accompanied by pain relief, improved pancreatic secretory function and quality of life.
Conclusion: Pancreatic head resection in patients with chronic pancreatitis should be performed within 3 years after clinical manifestation. Resection of more than 50% of the pancreatic head with extraction of MPD-stones ensures pain relief, better endocrine and exocrine function, as well as higher QoL in long-term follow-up period.
Databáze: MEDLINE