Assuntos
Adenocarcinoma/cirurgia , Artéria Hepática/cirurgia , Pâncreas/cirurgia , Neoplasias Pancreáticas/cirurgia , Pancreaticoduodenectomia/métodos , Veia Porta/cirurgia , Adenocarcinoma/irrigação sanguínea , Adenocarcinoma/patologia , Anastomose Cirúrgica , Feminino , Humanos , Pessoa de Meia-Idade , Pâncreas/irrigação sanguínea , Pâncreas/patologia , Neoplasias Pancreáticas/irrigação sanguínea , Neoplasias Pancreáticas/patologiaAssuntos
Hemorragia Gastrointestinal/cirurgia , Tumores do Estroma Gastrointestinal/cirurgia , Neoplasias do Jejuno/cirurgia , Jejuno/cirurgia , Anastomose Cirúrgica/métodos , Hemorragia Gastrointestinal/complicações , Hemorragia Gastrointestinal/diagnóstico por imagem , Hemorragia Gastrointestinal/patologia , Tumores do Estroma Gastrointestinal/complicações , Tumores do Estroma Gastrointestinal/diagnóstico por imagem , Tumores do Estroma Gastrointestinal/patologia , Humanos , Neoplasias do Jejuno/complicações , Neoplasias do Jejuno/diagnóstico por imagem , Neoplasias do Jejuno/patologia , Jejuno/diagnóstico por imagem , Jejuno/patologia , Masculino , Pessoa de Meia-Idade , Radiografia , Resultado do TratamentoRESUMO
In 2009-2013 yrs in 7 patients, suffering insulin-producing pancreatic tumors, the ASVS-test was conducted, the result of which was compared with data of standard methods of investigation, including abdominal ultrasound, computer tomography and magnetic resonance imaging. The insuloma enucleation was performed in 3 patients, distal subtotal pancreatectomy with splenectomy--in 1 and the completed total pancreatectomy--in 1. The ASVS-test conduction is indicated in patients with diagnosed hyperinsulinism while impossibility to perform a topic diagnosis of insulinoma, in accordance to data of other noninvasive methods of diagnosis.
Assuntos
Gluconato de Cálcio , Hiperinsulinismo/diagnóstico , Insulinoma/diagnóstico , Pâncreas/cirurgia , Neoplasias Pancreáticas/diagnóstico , Adulto , Idoso , Gluconato de Cálcio/administração & dosagem , Feminino , Humanos , Hiperinsulinismo/complicações , Hiperinsulinismo/patologia , Hiperinsulinismo/cirurgia , Infusões Intra-Arteriais , Insulina/sangue , Insulinoma/complicações , Insulinoma/patologia , Insulinoma/cirurgia , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Pâncreas/patologia , Pancreatectomia , Neoplasias Pancreáticas/complicações , Neoplasias Pancreáticas/patologia , Neoplasias Pancreáticas/cirurgia , Esplenectomia , Tomografia Computadorizada por Raios XRESUMO
In 115 patients, suffering malignant pancreatic tumors as well as those, localized in periampullar zone, a CT angiography was performed preoperatively to study up the variants of vascular anatomy. The data obtained were depicted by a surgeon, anatomic variants of truncus coeliacus and mesenterical vessels were recorded in accordance with classification of Michels, Hiatt. Individualized approach for surgical treatment, using CT angiography data, was applied. In 30 patients the operative intervention with the vessels resection was performed and in 6--a no-touch method. Distal pancreatic resection, using the RAMPS technology. was performed in 7 patients for malignant tumors. Complications have had occurred in 12 (10%) patients, 2 (1.7%) of them died. Lethality after operations with vessels resection have constituted 6.6%. The data on variants of vascular anatomy, obtained preoperatively, have permitted to escape massive intraoperative blood loss with subsequent irreversible necrotic changes in the abdominal cavity organs.