ABSTRACT
Radical surgery for tumors of the left anatomical and surgical segment of the pancreas proved for distal resection in various versions, central resection and enucleation of tumors. The causes of early postoperative complications and mortality in 129 patients aged from 14 to 81 years, operated on for neoplastic lesions of the left anatomical segment of the pancreas in the period from 2009 to 2014 were analysed. The influence of various factors of risk of complications and mortality were studied in particular, extended resection, for tumor invasion of adjacent organs, and adjacent vessels.
Subject(s)
Adenocarcinoma/surgery , Liver Neoplasms/surgery , Pancreatic Neoplasms/surgery , Postoperative Complications , Splenic Neoplasms/surgery , Vascular Neoplasms/surgery , Adenocarcinoma/blood supply , Adenocarcinoma/mortality , Adenocarcinoma/secondary , Adolescent , Adult , Aged , Aged, 80 and over , Female , Humans , Liver Neoplasms/blood supply , Liver Neoplasms/mortality , Liver Neoplasms/secondary , Male , Middle Aged , Pancreas/blood supply , Pancreas/pathology , Pancreas/surgery , Pancreatectomy/methods , Pancreatic Neoplasms/blood supply , Pancreatic Neoplasms/mortality , Pancreatic Neoplasms/pathology , Postoperative Period , Retrospective Studies , Risk Factors , Splenic Neoplasms/blood supply , Splenic Neoplasms/mortality , Splenic Neoplasms/secondary , Survival Analysis , Vascular Neoplasms/blood supply , Vascular Neoplasms/mortality , Vascular Neoplasms/secondaryABSTRACT
The results of treatment of 231 patients, suffering tumoral affection of pancreatic left anatomical segment in period of 2009-2013 yrs were analyzed. Individualized approach, using modern technologies, was applied. Radical operations were performed in 129 patients, ageing 14-81 yrs old, including pancreatic distal resections in various modifications, central resection and tumoral enucleation. Possibilities of the extended pancreatic resection performance were studied in conditions of tumoral invasion of adjacent organs, regional vessels, as well as impact of such interventions on postoperative complications and lethality rate. While performing pancreatic subtotal distal resection with simultant resection of affected main venous vessels and adjacent organs the operative intervention risk is enhanced, but possibilities of a radical operations performance in previously considered inoperable patients are expanding.
Subject(s)
Adenocarcinoma/surgery , Cystadenocarcinoma/surgery , Pancreas/surgery , Pancreatectomy/methods , Pancreatic Neoplasms/surgery , Postoperative Complications/prevention & control , Adenocarcinoma/blood supply , Adenocarcinoma/mortality , Adenocarcinoma/pathology , Adolescent , Adult , Aged , Aged, 80 and over , Cystadenocarcinoma/blood supply , Cystadenocarcinoma/mortality , Cystadenocarcinoma/pathology , Female , Hepatic Veins/pathology , Hepatic Veins/surgery , Humans , Male , Mesenteric Veins/pathology , Mesenteric Veins/surgery , Middle Aged , Minimally Invasive Surgical Procedures , Neoplasm Metastasis , Pancreas/blood supply , Pancreas/pathology , Pancreatic Neoplasms/blood supply , Pancreatic Neoplasms/mortality , Pancreatic Neoplasms/pathology , Retrospective Studies , Risk , Survival AnalysisABSTRACT
Experience of pancreaticoduodenal resection performance was summarized in 163 patients in 2005-2009 yrs. Duodeno(gastro)enterostomy was formed in anterior position, taking an objective to reduce the risk of postoperative gastrostasis occurrence; and formation of invagination ductojejunal anastomosis--for prophylaxis of pancreatogenic complications. External pancreatic duct drainage and medicinal therapy conduction do not guarantee reduction of the postoperative complications occurrence risk.
Subject(s)
Duodenal Neoplasms/surgery , Pancreatic Neoplasms/surgery , Pancreaticoduodenectomy/adverse effects , Pancreatitis/prevention & control , Postoperative Complications , Anastomosis, Surgical/methods , Anti-Inflammatory Agents/therapeutic use , Drainage/methods , Duodenal Neoplasms/pathology , Duodenum/pathology , Duodenum/surgery , Humans , Pancreas/pathology , Pancreas/surgery , Pancreatic Neoplasms/pathology , Pancreaticoduodenectomy/methods , Pancreatitis/etiology , Pancreatitis/pathology , Pancreatitis/surgeryABSTRACT
Experience of their own on performance of pancreatic resection interventions, using laparoscopic access, conducted in the clinic in 2009 - 2013 yrs, was presented. In 8 patients laparoscopic distal pancreatic resection was conducted, in 5--laparoscopic enucleation of pancreatic tumor, in 1--laparoscopic pancreaticoduodenal resection. The results were compared with such after open operations, performed in this period of time. There was not a trustworthy difference in the postoperative complications rate, intraoperative blood loss severity and the distal resection duration. The patient stationary treatment duration was trustworthy less after conduction of laparoscopic operations. The intraoperative blood loss severity and duration of laparoscopic enucleation of pancreatic tumor are trustworthy less.
Subject(s)
Adenocarcinoma/surgery , Duodenum/surgery , Pancreas/surgery , Pancreatic Neoplasms/surgery , Adenocarcinoma/pathology , Blood Loss, Surgical/prevention & control , Duodenum/pathology , Humans , Laparoscopy , Length of Stay , Pancreas/pathology , Pancreatectomy , Pancreatic Neoplasms/pathology , Pancreaticoduodenectomy , Postoperative Complications/prevention & control , Retrospective Studies , Time FactorsSubject(s)
Laparoscopy/methods , Pancreas/surgery , Pancreatectomy/methods , Pancreatic Neoplasms/surgery , Female , Humans , Laparoscopy/instrumentation , Pancreas/diagnostic imaging , Pancreas/pathology , Pancreatectomy/rehabilitation , Pancreatic Neoplasms/diagnosis , Pancreatic Neoplasms/diagnostic imaging , Pancreatic Neoplasms/pathology , Radiography , Young AdultABSTRACT
Results of treatment in 114 patients with duodenal big papilla (DBP) tumor were adduced. Radical operations were performed in 63 patients, including in 27--pancreatoduodenal resection, in 36--local resection of DBP. Postoperative complications were occurred in 14% of patients. Postoperative lethality was 0.9%. Indexes of five-year survival were higher in patients, in which local resection of DBP was performed.