DOI: https://doi.org/10.22263/2312-4156.2017.5.7
Shchastny A.T.
Modern principles of chronic pancreatitis diagnosing and treatment
Vitebsk State Order of Peoples’ Friendship Medical University, Vitebsk, Republic of Belarus
Vestnik VGMU. 2017;16(5):7-20.
Abstract.
Chronic pancreatitis is one of the leading diseases in gastroenterology, it makes up 8-9% in the structure of gastrointestinal tract organs morbidity, and in that of general pathology – 0,5%.
The process of fibrotic transformation with gradual replacement of pancreatic parenchyma leads to exocrine insufficiency and maldigestion, loss of weight, and at an advanced stage to diabetes mellitus. In addition to exocrine and endocrine dysfunction such complications as stenosis of the duodenum, common bile duct and pancreatic duct develop. Long progression of the disease results in fatal outcome in 20,8 – 30% of patients with chronic pancreatitis.
Pain syndrome is the most common indication for operation with resection or drainage variants. The advantage of simple drainage operation is maximum preservation of the pancreas tissue. However, fibrously changed tissues are not removed during drainage operations, especially those located in the head of the pancreas, which leads to the unsatisfactory outcomes in a considerable number of patients and requires the performance of resection interventions. There is no standard operation that is used for the elimination of pain and complications in chronic pancreatitis and meets the requirements set to an ideal one. Firstly, none of the operations eliminates the structural disturbances of the pancreas and the complications associated with chronic pancreatitis. Secondly, the choice of an operation is difficult for those patients, in whom pain is the only symptom of the disease.
Key words: chronic pancreatitis, pancreas, minimally invasive surgery, pancreatic cysts, laparoscopic techniques.
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Information about authors:
Shchastny A.T. – Doctor of Medical Sciences, rector, professor of the Chair of Surgery of the Faculty for Advanced Training & Retraining, Vitebsk State Order of Peoples’ Friendship Medical University.
Correspondence address: Republic of Belarus, 210023, Vitebsk, 27 Frunze ave., Vitebsk State Order of Peoples’ Friendship Medical University, Chair of Surgery of the Faculty for Advanced Training & Retraining. E-mail: Этот адрес электронной почты защищён от спам-ботов. У вас должен быть включен JavaScript для просмотра. – Anatoly T. Shchastny.
