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Zakharova M.A.

Chaika Clinics

Kriger A.G.

Russian Research Center of Radiology;
Russian Medical Academy of Postgraduate Education

Karmazanovsky G.G.

Vishnevsky National Medical Research Center of Surgery

Kondratyev E.V.

Vishnevsky National Medical Research Center of Surgery

Kalinin D.V.

National Medical Research Center of Surgery named after A.V. Vishnevsky of Ministry of health of the Russian Federation

Glotov A.V.

National Medical Research Center of Surgery named after A.V. Vishnevsky of Ministry of health of the Russian Federation

Effect of morphological state of pancreatic parenchyma on the long-term outcome of surgery for chronic pancreatitis

Authors:

Zakharova M.A., Kriger A.G., Karmazanovsky G.G., Kondratyev E.V., Kalinin D.V., Glotov A.V.

More about the authors

Journal: Pirogov Russian Journal of Surgery. 2021;(5): 42‑49

DOI: 10.17116/hirurgia202105142

Views: 1267

Downloaded: 22

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Table of contents

To cite this article:

Zakharova MA, Kriger AG, Karmazanovsky GG, Kondratyev EV, Kalinin DV, Glotov AV. Effect of morphological state of pancreatic parenchyma on the long-term outcome of surgery for chronic pancreatitis. Pirogov Russian Journal of Surgery. 2021;(5):42‑49. (In Russ.)
https://doi.org/10.17116/hirurgia202105142

Подписка 2025 (Pirogov Russian Journal of Surgery)
МСФ на ЯМ
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OBJECTIVE

To determine the effect of baseline morphological state of the pancreas on the long-term outcomes of duodenum-preserving pancreatic head resection (DPPHR).

MATERIAL AND METHODS

The study included 104 patients with chronic pancreatitis (CP), who underwent DPPHR in 2014—2019. Pain syndrome, exocrine and endocrine pancreatic insufficiency and quality of life (QoL) were assessed in long-term postoperative period. Patients were stratified depending on CT enhancement of pancreatic parenchyma as an indicator of fibrosis and amount of preserved acinar cells in resected pancreatic tissue.

RESULTS. S

Ignificant relief of pain syndrome in long-term period was observed in patients with higher density of pancreatic tissue in venous phase of CT compared to delayed phase. Moreover, these patients needed less additional enzyme intake and had higher QoL. Exocrine insufficiency depended on the number of preserved acinar cells. The percentage of preserved acinar cells also affects the QoL of patients with CP. There were no correlations between endocrine insufficiency and CT-findings, as well as the number of preserved acinar cells.

CONCLUSION

Higher CT-density of pancreatic parenchyma in venous phase indicates a lesser degree of fibrosis. It is a favorable prognostic factor for postoperative pain relief and preservation of exocrine function. The percentage of preserved acinar cells in the resected pancreatic tissue is a reliable predictor of exocrine insufficiency.

Keywords:

chronic pancreatitis
long-term outcome
duodenum-preserving pancreatic head resection
acinar cells
computed tomography

Authors:

Zakharova M.A.

Chaika Clinics

Kriger A.G.

Russian Research Center of Radiology;
Russian Medical Academy of Postgraduate Education

Karmazanovsky G.G.

Vishnevsky National Medical Research Center of Surgery

Kondratyev E.V.

Vishnevsky National Medical Research Center of Surgery

Kalinin D.V.

National Medical Research Center of Surgery named after A.V. Vishnevsky of Ministry of health of the Russian Federation

Glotov A.V.

National Medical Research Center of Surgery named after A.V. Vishnevsky of Ministry of health of the Russian Federation

Received:

17.06.2020

Accepted:

20.08.2020

List of references:

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  2. Sinha A, Singh VK, Cruise M, Afghani E, Matsukuma K, Ali S, Andersen DK, Makary MA, Raman SP, Fishman EK, Zaheer A. Abdominal CT predictors of fibrosis in patients with chronic pancreatitis undergoing surgery. Eur Radiol. 2015;25(5):1339-1346. Epub 2014 Dec 4. PubMed PMID: 25471477. https://doi.org/10.1007/s00330-014-3526-x
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  10. Dasyam AK, Shah ZK, Tirkes T, Dasyam N, Borhani AA. Cross-sectional imaging-based severity scoring of chronic pancreatitis: why it is necessary and how it can be done. Abdom Radiol (NY). 2020;45(5):1447-1457. https://doi.org/10.1007/s00261-019-02218-6
  11. Cooper MA, Makary MA, Ng J, Cui Y, Singh VK, Matsukuma K, Andersen DK. Extent of pancreatic fibrosis as a determinant of symptom resolution after the Frey procedure: a clinico-pathologic analysis. J Gastrointest Surg. 2013;17(4):682-687.  https://doi.org/10.1007/s11605-012-2110-4
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