Aims/Objectives. The purpose of our research was studying of the reasons to increase head of the pancreas with a comparative estimation of morphological changes and outcomes of surgical treatment at patients by whom the local resection of the head of the pancreas with duodenum- preserving has been executed. Materials and methods. Results of the surgical treatment and morphological changes of 104 patients were studied: a local resection of the head of the pancreas with longitudinal pancreaticojejunostomy (LRHP+LPJ, n = 33), LRHP without LPJ (LRHP—LPJ' n = 36) and a local resection of the head and isthmus of the pancreas without LPJ (LRHIP—LPJ, n = 35). Results and discussion. In comparison groups has been revealed statistically significant distinction (Н = 17,357, df = 2, р = 0,002) on the sizes of the pancreas head. In their groups has been revealed statistically significant distinction in the sizes intrapancreatic pseudocysts in the pancreas head (Н = 8,912, df = 2, р = 0,012). The Spearman correlation (Spearman, p) had been found out statistically significant strong direct dependence between variables «the sizes of the pancreas head» and «the sizes intrapancreatic pseudocysts in the pancreas head «in comparison groups: LRHP+LPJ p = +0,73, р < 0,0001, LRHP-LPJ p = +0,78, р < 0,0001, LRHIP-LPJ p = +0,76, р < 0,0001. Between three groups of the patients by quantity of complications after operation were statistically significant (x2 = 10,644, df = 2, р = 0,005). In comparison groups has not been established distinctions on presence of the complications with focal or diffuse perilobular fibrosis — С < 0,200 or intralobular fibrosis — С < 0,265, and presence periductal fibrosis — С = 0,124. Conclusions. The sizes of the pancreas' head in the compared groups directly depend on the sizes intrapancreatic pseudocysts in the pancreas head. The probability of the complications' development after operation is not depended with focal or diffuse perilobular fibrosis or intralobular fibrosis and presence periductal fibrosis.
The objectives of the research were to compare the outcomes application of the SP-3 generation TachoKomb at the stage of reconstruction during resection with drainage operations (RDO) in patients suffering from various complications chronic pancreatitis (CP). It was performed prospective research by several criteria without randomization. Methods: From 01.01.2008 to 31.12.2012 in the Department of Hepatobiliary Surgery in the City Clinical Hospital of Emergency Care, (Minsk) 183 patients with various complicated forms of CP underwent RDO surgery. We are performed of pancreatodigestive, biliodigestive, enteroenteroanastomosis according to the principle of the performance «one-row uninterrupted monofilament suture» with the covering surface of all anastomosis by fibrinogencoated collagen patch TahoKomb. Treatment results for all groups were analyzed with respect to postoperative complications and morbidity (within 30 days after the operation). The results were studied using nonparametric values the software package Statistica 6.0 for Windows XP. These values ÎAE < 0.05 were considered significant. Results: In the immediate postoperative period more complications were observed in the pancreatoduodenectomy (PPPD) and Frey procedure (FP) groups (ÎAE <0.05), than Partingtone-Rochelle procedure (LPJ) and Roux-en-Y pancreatocystojejunostomy (PCJ). Application of the uniform principle of performance of a reconstructive stage of operations in all groups of patients has allowed improving results of treatment authentically. Quality and quantity of complications in the analysed groups statistically significant distinction (H = 10,105 is noted at value Ïz2 -7,815). After performance PPPD and FP the complications set forth above have been registered at more cases as operations were carried out against more terrible complications CP. Conclusions: The received results (ÎAE <0.05) to confirm expediency of application of the uniform principle performance «one-row uninterrupted monofilament suture» and covering the surface of all anastomosis with fibrinogencoated collagen patch TahoKomb.
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