The pancreas is an organ that plays a key role in the digestive process, preparing food ingredients such as proteins, fats and carbohydrates for adequate absorption in the small intestine. Today, a wide range of pathological conditions is known in which the tissue of the pancreas is affected and its functions are lost. The literature review examined various diseases that phenotypically manifest as pancreatitis, as well as various diagnostic and therapeutic strategies.
The article is devoted to the experience of surgical treatment of pathology of the pancreas at the Center for the Treatment of Developmental Anomalies and Diseases of the Hepatopancreatobiliary System in Children on the basis of the Children’s City Clinical Hospital No. 13 named after NF Filatova: annular pancreas, acute and chronic pancreatitis, tumors and cysts of the pancreas. From 2016 to 2020, more than 267 reconstructive interventions on the pancreas were performed, including longitudinal and transverse pancreatojejunoanastamosis, pancreatoduodenal resection, cystoenteroanastamosis, sectoral and total resection of the pancreas. In the postoperative period, the most severe complication in this category of patients was arrosive bleeding, which is the main cause of all deaths after surgery.
Aim. The paper presents the experience of treatment of echinococcal cysts in children, which reflects most of the existing methods of treatment.Materials and methods. From 2010 to 2021, 81 patients with hepatic echinococcosis aged from 3 to 17 years (average 14.3 ± 1.3) were treated at the bases of the Department of Pediatric Surgeons of the Pirogov Russian State Medical University. All patients were examined according to the standard procedure, including: general clinical examination, examination of liver function, ultrasonography, chest X-ray, CT scan, blood test for IgG to echinococcus antigens. All children were divided into 2 groups according to the type of the surgery: in the group 1, 27 (33.3%) children underwent laparoscopic surgery; in the group 2, 54 (66.7%) children – laparotomy.Results. The treatment duration accounted 12.5 ± 3.1 days in group 1 and 9.2 ± 1.3 days in group 2 (p < 0.0067). In the group 1 the drainage duration was higher (6.8 ± 0.6) than in the group 2 (4.1 ± 0.3) (p < 0.03). Complications occurred in 7 patients, relapse of cysts – in 2 patients.Conclusion. Children with echinococcal cysts in Central Russia occur with a constant frequency and require to apply modern approaches in diagnosis and treatment. The classification and treatment protocol of echinococcosis, adopted by WHO, are easy-to-use and proves its effectiveness. There is no significant difference in germicidal agents’ effect on echinococcus and the effect on the development of relapse. The method of selection in the treatment of solitary and superficial cysts is laparoscopic interference with the mandatory application of a PAIR and a high-power aspirator. An important stage of the interference is the treatment of the fibrous capsule of the cyst, if it is impossible to completely remove it, with an argon-plasma coagulator.
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