RESUMO
15 patients with solid-pseudopapillary tumors of the pancreas (SPTP) were investigated. There were no specific clinical signs of the disease revealed; the major common clinical sign was the upper abdominal pain. Of the diagnostic methods the ultrasound together with endoscopic ultrasound, computed tomography and magnetic resonance imaging were used. Specific diagnostic feature of SPTP is the heterogenous structure and even contours and capsule. Any changes of pancreatic duct are untypical. All 15 patients were operated on. The intraoperative urgent histological analyze together with postoperative immunohystochemical investigation were performed in all cases. 11 patients developed the postoperative pancreatitis. The long-term follow up results were obtained in 15 patients. The disease progression was registered in one case.
Assuntos
Ductos Pancreáticos/patologia , Ductos Pancreáticos/cirurgia , Neoplasias Pancreáticas/diagnóstico , Neoplasias Pancreáticas/terapia , Adolescente , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias , Adulto JovemRESUMO
The indications to Frey operation are severe pain syndrome and pancreatic hypertension, caused by concrements and strictures of the main pancreatic duct and/or postnecrotic pancreatic cysts. The pancreaticojejunoanastomosis is performed on the isolated by Roux intestinal loop. The average operating time was 4.62±1.39 hours. 28,3% of the operated patients developed various postoperative complications. 2 (6.7%) patients had the anastomosis insufficiency; the 2 patients had intraanastomotic bleeding and 1 patient had the arrosive bleeding caused by pancreonecrosis. 2 patients had external pancreatic fistulae. 1 patient died. The average hospital stay after the operation was 12±4 days.
Assuntos
Pâncreas/cirurgia , Pancreaticojejunostomia/métodos , Pancreatite/cirurgia , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pancreaticojejunostomia/efeitos adversos , Adulto JovemRESUMO
4 clinical cases of metastatic invasion of pancreas by renal cancer were analyzed. The main features were the late metastatic revealance and the absence of specific clinical picture. The radiodiagnostics showed signs similar to neuroendocrine tumors of the pancreas, which complicated the diagnosis. All the patients were operated on - the resection of the pancreas was performed.
Assuntos
Carcinoma de Células Renais/secundário , Neoplasias Renais/patologia , Neoplasias Pancreáticas/secundário , Biópsia por Agulha , Carcinoma de Células Renais/diagnóstico , Carcinoma de Células Renais/cirurgia , Diagnóstico Diferencial , Feminino , Seguimentos , Humanos , Neoplasias Renais/diagnóstico por imagem , Pessoa de Meia-Idade , Pancreatectomia , Neoplasias Pancreáticas/diagnóstico , Neoplasias Pancreáticas/cirurgia , Tomografia Computadorizada Espiral , UltrassonografiaRESUMO
The results of 302 operations on the pancreas were analyzed: of them 107 were pancreatoduodenal resections; 67 were distal resections of the pancreas; 74 were various resections of the head of the pancreas and middle resections and 54 other operations. The postoperative pancreatitis was registered in 178 patients. The preventive use of the octreotide intraoperatively and in early postoperative period showed no influence on the frequency and severity of the postoperative pancreatitis. The ultrasound was the optimal screening diagnostig method, whereas the computed tomography was the best in pancreonecrosis diagnostics and the volume of the pancreatic tissue damaged. Of 178 patients with the postoperative pancreatitis 17 died, the lethality rate was 9.5%.