scholarly journals RESECTION OPERATIONS IN SURGICAL TREATMENT OF PATIENTS WITH CHRONIC PANCREATITIS COMPLICATED BY BILIARY HYPERTENSION

2016 ◽  
Vol 3 ◽  
pp. 50-56
Author(s):  
Volodymyr Pylypchuk ◽  
Andriy Yavorskyy ◽  
Galyna Shabat ◽  
Marco Marino Vito

Surgical treatment was applied in 145 patients with complicated forms of chronic pancreatitis (CP) at the department of surgery of the Ivano-Frankivsk Regional Clinical Hospital in 2009–2016. Fourty-nine (33.7 %) patients had symptoms of biliary hypertension (BH); in five (3.4 %) of them BH was combined with chronic duodenal obstruction (CDO), the other 5 (3.4 %) patients had a combination of BH+CDP and local venous hypertension of pancreaticobiliary area vessels. Resection-type surgeries were applied in 28 (57.1 %) patients with CP complicated by BH. Intraoperative monitoring of biliary pressure was used in 17 patients in the process of duodenum-preserving resections of the pancreas. Frey’s procedure was applied to 20 (71.4 %) patients, in whom BH persisted after the resection stage of the surgery; Frey’s procedure was supplemented by interventions on bile ducts: hepaticoenteroanastomosis was applied in 12 patients, excision of pancreas lingula was applied in one patient, internal biliopancreatic anastomosis was applied in one patient. Berne modification was used in 2 (7.2 %) patients, and pancreaticoduodenal resection (PDR) according to Whipple – in 6 (21.4 %) patients. Remote results were studied in 19 (67.8 %) patients. Patients after duodenum-preserving resections had the best quality of life indicators, for BH signs were absent.

2019 ◽  
Vol 6 (3) ◽  
pp. 108-114 ◽  
Author(s):  
A. D. Sergienko ◽  
V. E. Khoronenko ◽  
E. V. Gameeva ◽  
A. B. Ryabov ◽  
V. M. Khomyakov

Purpose of the study. To determine the effect of nutritional deficiency and nutritional therapy on the quality of life of patients with gastric cancer at the stage of surgical treatment. Patients and methods. In Thoracoabdominal Department of P. Herzen Moscow Oncology Research Institute within 2017– 2019 the quality of life at the stage of surgical treatment of gastric malignant neoplasms was evaluated in 62 patients (36 men and 26 women) aged 34 to 79 years (mean age 61.9 ± 9.55). At the outpatient stage, patients were divided into 2 groups: in the 1st (main) group, patients received nutritive support with specialized mixtures for 10 days before hospitalization, in the 2nd (control) group, patients were asked to follow a high-protein diet without adding specialized mixtures. The quality of life assessment was carried out on the basis of the EORTC-QLQ-C30 Questionnaire, which patients received on the day of hospitalization. Patients repeatedly filled in EORTC-QLQ-C30 Questionnaire before discharge from the hospital, which allowed to assess the dynamics of the quality of life indicators of the studied patients. The study groups were comparable in social and medical indicators. Results. The analysis of the survey results showed that the “general state of health” in the studied groups at the stage of hospitalization is estimated �bove average. Also, in both groups there is a positive dynamics in the values of the above indicator before discharge. Patients of the 1st group who received specialized nutritional mixtures, developed the statistical significance of the differences in the assessment of the quality of life upon admission and before discharge. Thus, it can be argued that nutritional therapy had a significant positive impact on the quality of life in terms of “general health”, in contrast to the control group of patients who did not receive specialized nutritional therapy. There was a general tendency toward an increase in the quality of life indicators at admission and before discharge on all scores of the questionnaire in groups. Thisis a positive assessment by patients of their condition after providing them with medical services. In this case, the discomfort from the symptoms accompanying the disease is reduced, which is confirmed by the scoring results. Statistically significant differences in the assessment of symptoms occur in the study group. Patients having received nutritional therapy noted a decrease in pain, an improvement in the processes of assimilation of food, as well as an improvement in well-being, physical condition, an increase in general tone and energy, a surge of strength and a sense of vitality. In “decreased appetite”score the indices of patients in the main group decreased by more than 3 times, i. e. their appetite improved significantly under treatment. Improving appetite in patients of the main group led to an improvement in the functioning of the gastrointestinal tract as a whole. Patients in this group noted an improvement in digestion and bowel movements. Conclusion The study showed that the quality of life of patients with gastric cancer largely depends on their nutritional deficiency, and nutritional therapy at the stages of surgical treatment, in turn, can significantly improve its results, including in the aspect of their perception by patients. Using the general EORTC QLQ-C30 questionnaire is one of the available methods for assessing the quality of life in patients with gastric cancer.


2020 ◽  
Vol 50 (2) ◽  
Author(s):  
Claudio Murillo Matamoros ◽  
Marta Muñiz Muñoz ◽  
Miguel Suárez Matías ◽  
Pablo Olcina Domínguez ◽  
Laura Valiente González ◽  
...  

Groove pancreatitis is a very uncommon type of chronic pancreatitis of uncertain etiology that occurs in the pancreatoduodenal groove. Despite the great advances in imaging techniques, making a definitive diagnosis is difficult because of the complex anatomy of this area. Therefore, surgical treatment is often required due to the impossibility of excluding malignancy. We present the case of a patient with a history of chronic pancreatitis admitted due to duodenal obstruction. The diagnosis was difficult, especially for the need to exclude the neoplasms of the duodenal-pancreatic area. Endoscopic ultrasound was essential to establish a definitive diagnosis, allowing FNAP and correct assessment of the duodenal wall.


Author(s):  
M. A. Zakharova ◽  
A. V. Smirnov ◽  
D. S. Gorin ◽  
E. A. Vorobyeva ◽  
A. G. Kriger

2017 ◽  
Vol 98 (5) ◽  
pp. 709-713
Author(s):  
S V Tarasenko ◽  
A A Natal’skiy ◽  
O V Zaytsev ◽  
S N Sokolova ◽  
A Yu Bogomolov ◽  
...  

Aim. Comparative analysis of the long-term results of surgical treatment of patients with chronic pancreatitis. Methods. The study included patients with complicated clinical forms of chronic pancreatitis including: ductal pancreatic hypertension, main pancreatic duct concrements, marked fibrous restructuring of the pancreatic parenchyma and presence of calcifications, presence of biliary hypertension, portal hypertension syndrome, duodenostasis syndrome, chronic abdominal pain syndrome, retention and post-necrotic cysts. Patients were divided into 3 groups: group 1 included patients with chronic pancreatitis receiving conservative treatment (n=32), group 2 - patients who underwent the Frey pancreatic resection (n=24) and group 3 - Beger pancreatic resection (n=9). The assessment was performed according to the most spread specific questionnaire in gastroenterology GSRS (Gastrointestinal Symptom Rating Scale). Results. The quality of life of patients who underwent both Frey and Beger pancreatic resection was significantly higher than the quality of life of patients in whom chronic pancreatitis was treated conservatively. Quality of life of patients who underwent Frey or Beger pancreatic resection did not differ significantly. Malabsorption syndrome has a significant effect on the quality of life of patients who underwent surgical treatment of chronic pancreatitis. The GSRS questionnaire demonstrated low sensitivity in detecting malabsorption syndrome. Conclusion. Quality of life of patients who underwent surgical treatment of chronic pancreatitis is statistically significantly higher than in patients receiving conservative treatment; correction of existing quality of life questionnaires is required in order to identify malabsorption syndrome.


2019 ◽  
pp. 244-251
Author(s):  
A. S. Yunusov ◽  
T. I. Garashchenko ◽  
P. I. Belavina ◽  
A. G. Ryazanskaya ◽  
E. V. Molodtsova ◽  
...  

Rationale. Currently, the literature describes about 374 cases of Marshall syndrome. According to some authors, the prevalence of Marshall syndrome is 2.3 per 10,000 children, in general, the epidemiology of PFAPA syndrome in the pediatric population is unknown.Purpose. The aim of our study is to justify surgical treatment in children with Marshall syndrome. Objectives. The objectives of this study are to give a comparative assessment of the effectiveness of tonsillectomy and adenotonzyllectomy for this syndrome and to evaluate the quality of life indicators before and after surgical treatment.Materials and methods. The study included 26 patients with Marshall syndrome, of which 18 patients underwent adenotonzyllectomy and 8 patients underwent bilateral tonsillectomy. A clinical case of a typical manifestation of Marshall syndrome is also described, and follow-up results of the effectiveness of surgical treatment for Marshall syndrome are presented. In the course of the work, an adapted questionnaire was developed to assess the quality of life of parents of children with Marshall syndrome.Results. The result of our work is the fact that in relation to the relief of PFAPA-syndrome, children of preschool and primary school age have more effective adenotonsillectomy (88.2%), while tonsillectomy was effective only in 55.6% of patients.Conclusion. A multidisciplinary approach is required to address the diagnosis and treatment of Marshall syndrome.


2020 ◽  
Vol 9 (3) ◽  
pp. 1208-1216 ◽  

Patients with Hashimoto’s thyroiditis have hypothyroidism, goiter, and extrathyroidal lesions. Substitution therapy with thyroxine drugs in some cases is not effective. The work studies the feasibility of using surgical treatment – removal of the active site of autoimmune aggression. To study the effect of thyroidectomy on the quality of life of patients with Hashimoto’s thyroiditis with extrathyroidal manifestations. Sixty-one patients with Hashimoto’s thyroiditis were examined. Among them 29 patients were treated with drugs (control group) and 32 with surgery (main group). The quality of life was studied using the SF-36 questionnaire. TSH levels within euthyroidism were controlled and the level of antibodies to thyroperoxidase was determined. Two years after the surgical treatment, the studied quality of life indicators was improved significantly. The growth in individual indicators ranged from 34 (role-functioning, conditioned by emotional state) to 57 % (vital activity), and the overall health indicator increased by 52 %. The level of antibodies to peroxidase decreased almost to the norm. In the group of patients receiving drug treatment, overall quality of life indicators did not change significantly, but there was a tendency to worsen. The level of antibodies to peroxidase remained at high rates without significant changes. Surgical treatment of patients with Hashimoto’s thyroiditis improves the quality of life. The level of antibodies to thyroperoxidase after thyroidectomy is reduced to almost physiologically significant indicators.


2019 ◽  
Vol 1 (6) ◽  
pp. 56-60
Author(s):  
N. B. Gubergrits ◽  
E. A. Krylova ◽  
E. Yu. Plotnikova

In 72 patients with chronic pancreatitis were studied quality of life indicators using a common questionnaire the SF-36 (Short Form-36, Healt Status Survey) in the dynamics of treatment. It was established that the disease affects the quality of life of patients, affecting all levels of life:physical, emotional, role, psychological, social functioning. After treatment, the quality of life of patients significantly improved both indicators of physical and social health of patients increased the overall tone and physical activity during the day, improves sleep at night.


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