New methods in the surgical treatment of patients with chronic pancreatitis
Shalimov, A.A.; Shalimov, S.A.; Lifshits, I.Z.; Kozhara, S.P.; Usenko, A.I.
Klinicheskaia Khirurgiia 11: 1-5
1989
ISSN/ISBN: 0023-2130 PMID: 2625845 Document Number: 336669
The analysis of the 10-year experience with surgical treatment of 719 patients with chronic pancreatitis is presented. Of them in 461, the direct interventions on the pancreas were performed. Drainage operations were performed in 270 patients, the lethality was 3.3%, different modifications of pancreatic resection were used in 191 patients, the lethality was 8.3%. Together with the recognized interventions, the new ones--recanalization of the pancreatic duct with plasty of its wall, recanalization of the pancreatic duct by the small intestinal segment, anatomical resection of the pancreatic head were performed. The main requirements for the performance of pancreatic resection in patients with chronic pancreatitis were defined: resection within the limits of the irreversibly changed area of a gland; choice of a method for stump management with regard to functional state of a gland; restoration of physiologic pathways for passage of the food, bile and pancreatic secret. The surgical principles permitting to improve carbohydrate metabolism in patients after pancreatoduodenal resection have been developed.