Clinical forms and surgical strategy for chronic pancreatitis

Mirzoev I.A.; Medzhidov R.T.; Abdullaeva A.Z.; Magomedova S.M.

doi:https://doi.org/10.17116/hirurgia202303119

Mirzoev I.A.

Dagestan State Medical University

Medzhidov R.T.

Vishnevsky Republican Clinical Hospital

Abdullaeva A.Z.

Dagestan State Medical University

Magomedova S.M.

Dagestan State Medical University

Clinical forms and surgical strategy for chronic pancreatitis

Authors:

Mirzoev I.A., Medzhidov R.T., Abdullaeva A.Z., Magomedova S.M.

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Journal: Pirogov Russian Journal of Surgery. 2023;(3): 19‑27

DOI: 10.17116/hirurgia202303119

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To cite this article:

Mirzoev IA, Medzhidov RT, Abdullaeva AZ, Magomedova SM. Clinical forms and surgical strategy for chronic pancreatitis. Pirogov Russian Journal of Surgery. 2023;(3):19‑27. (In Russ.)
https://doi.org/10.17116/hirurgia202303119

Подписка 2026 Хирургия. Журнал им. Н.И. Пирогова (Pirogov Russian Journal of Surgery)

Использование инфографики авторами научных работ

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OBJECTIVE

To analyze treatment outcomes in patients with various forms of chronic pancreatitis.

MATERIAL AND METHODS

We analyzed 434 patients with chronic pancreatitis. These ones underwent 2879 different examinations to determine morphological type of pancreatitis and dynamics of pathological process, as well as substantiate treatment strategy and functional monitoring of various organs and systems. Morphological type A (Buchler et al. 2002) was present in 51.6% of cases, type B — 40.0%, type C — 4.3%. Cystic lesions were detected in 41.7% of cases, pancreatic calculi — 45.7%, choledocholithiasis — 19.1%, tubular stricture of distal choledochus — 21.4%, pancreatic duct enlargement — 95.7%, narrowing or interruption of the duct — 93.5%, communication of the duct with the cyst — in 17.4% of patients. Induration of pancreatic parenchyma was noted in 97% of patients, heterogeneous structure — 94.4%, enlargement of the pancreas — 10.8%, shrinkage of the gland — in 49.5% of cases. Surgical treatment was performed in 186 patients: ERCP + EPST in 8 patients, ERCP + EPST + pancreatic duct stenting in 2 patients, ERCP + EPST + wirsungotomy with stenting in 2 patients, laparotomy with hepaticocholedochojejunostomy in 6 patients, laparotomy with gastropancreatoduodenal resection in 19 patients, laparotomy with Puestow I procedure in 18 patients, Puestow II procedure in 34 patients, laparotomy + pancreatic tail resection + Duval procedure in 3 patients, laparotomy with Frey surgery in 19 cases, laparotomy and Beger procedure in 2 patients, external drainage of pseudocyst in 21 patients, endoscopic internal drainage of pseudocyst in 9 patients, laparotomy with cystodigestive anastomosis in 34 patients, excision of fistula and distal pancreatectomy in 9 cases).

RESULTS

Postoperative complications developed in 22 (11.8%) patients. Mortality rate was 2.2%.

Keywords:

chronic pancreatitis

morphological type

biliary hypertension

pancreatic hypertension

wirsungolithiasis

pancreatic duct stricture

pseudocyst

pancreatic fistulas

complications

Authors:

Mirzoev I.A.

Dagestan State Medical University

Medzhidov R.T.

Vishnevsky Republican Clinical Hospital

Abdullaeva A.Z.

Dagestan State Medical University

Magomedova S.M.

Dagestan State Medical University

Received:

18.06.2022

Accepted:

10.07.2022

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References:

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