3 research outputs found
The modern view on the problem of the surgical treatment of patients with pathology of the pancreas accompanied by obstructive jaundice
Catedra de chirurgie nr.2, Curs de chirurgie pediatricÄ, Universitatea NaČionalÄ de MedicinÄ, Odessa, Ucraina, Al XII-lea Congres al AsociaČiei Chirurgilor āNicolae Anestiadiā din Republica Moldova cu participare internaČionalÄ 23-25 septembrie 2015Introducere: Rezultatele tratamentului chirurgical la pacienČii cu patologie pancreaticÄ pe un fundal de icter mecanic depind nu
numai de cauza bolii de bazÄ, dar de asemenea de diagnosticul oportun, durata icterului Či volumul tratamentului chirurgical
realizat.
Scopul studiului a fost Ć®mbunÄtÄČirea rezultatelor tratamentului chirurgical al pacienČilor cu sindrom de icter mecanic prin
crearea unei metode de diagnostic diferenČiat al patologiei de bazÄ, cu determinarea ulterioarÄ a volumului intervenČiei
chirurgicale.
Material Či metode: Pe parcursul perioadei 2010-2015 Ć®n Clinica noastrÄ au fost supuČi tratamentului chirurgical 114 pacienČi
cu sindrom de icter mecanic. Algoritmul de diagnostic a inclus obigatoriu ultrasonografia, CT, MRI, FEGDS Či ERCP. Ćn unele
cazuri a fost efectuatÄ analiza geneticÄ pentru prezenČa unor tipuri de mutaČii genice specifice. Evident pentru leziunile maligne
ale pancreasului cefalic au fost verificaČi marcherii specifici oncogenici (CEA, CA 19-9). Cancerul de pancreas a fost confirmat la
42 (36,8%) pacienČi, diferite forme de pancreatitÄ cronicÄ a fost gÄsite la 72 (63,2%) pacienČi.
Rezultate: Decompresia asistatÄ laparoscopic sau cu ghidaj ultrasonografic a arborelui biliar a fost efectuatÄ la 96 (84,2%)
pacienČi. La 17 pacienČi cu pancreatitÄ cronicÄ s-a efectuat intervenČie chirurgicalÄ economÄ ā procedeul Beger Ć®n volumul
Bernese. La pacienČii rÄmaČi (55) s-a efectuat rezecČia pancreatoduodenalÄ (RPD) prin metode proprii. RPD pentru cancer s-a
efectuat la 42 pacienČi, 7 pacienČi au decedat. Rata de mortalitate a constituit 6.1%.The results of surgical treatment of patients with pathology of the pancreas on a background of jaundice is not only due to the nature of the underlying disease, but also its timely diagnosis, length of jaundice and volume of performed surgery. The aim of the study was to improve the results of surgical treatment of patients with obstructive jaundice syndrome by creating a new approach to the differential diagnostics of underlying disease with subsequent determining of the surgical intervention volume. Materials and methods_ From 2010 to 2015 in our clinic the surgical treatment of 114 patients with the obstructive jaundice syndrome was performed. The diagnostic algorithm includes the mandatory implementation of ultrasound, CT, MRI, FEGDS,ERCP. In certain cases, a genetic analysis for the presence of type-specific gene mutations was carried out. Obviously, for malignant lesions of the head of the pancreas verification of specific oncomarkers (CEA, CA 19-9) levels were estimated. Pancreatic cancer was verified in 42 (36.8%) patients, different forms of chronic pancreatitis were found in 72 (63.2%) patients. Results_ Ultrasound-guided or laparoscopy-assisted decompression of the biliary tree was performed in 96 (84.2%) patients. In17 patients with chronic pancreatitis sparing surgery in the volume of Bernese type of Begerās procedure was done. In the rest patients (55) pancreatico-duodenal resection (PDR) by own methods was performed. PDR for cancer is performed in 42patients, 7 patients died. The mortality rate was 6.1%