RESUMEN
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.
Asunto(s)
Gluconato de Calcio , Hiperinsulinismo/diagnóstico , Insulinoma/diagnóstico , Páncreas/cirugía , Neoplasias Pancreáticas/diagnóstico , Adulto , Anciano , Gluconato de Calcio/administración & dosificación , Femenino , Humanos , Hiperinsulinismo/complicaciones , Hiperinsulinismo/patología , Hiperinsulinismo/cirugía , Infusiones Intraarteriales , Insulina/sangre , Insulinoma/complicaciones , Insulinoma/patología , Insulinoma/cirugía , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Páncreas/patología , Pancreatectomía , Neoplasias Pancreáticas/complicaciones , Neoplasias Pancreáticas/patología , Neoplasias Pancreáticas/cirugía , Esplenectomía , Tomografía Computarizada por Rayos XRESUMEN
An analysis of treatment of 584 patients with complicated forms of chronic pancreatitis operated during 2000-2100 years was carried out. Quality of life of postoperative patients was estimated according to a technique of calculations of modules EORTC QLQ-C30 and EORTC QLQ-PAN26. The indicators of quality of life have improved by 19.7% in performance of saving duodenal outflow of operations of pancreatic juice. Change of the surgical strategy has led to decreased number of postoperative complications by 4.6% and to satisfactory long-term results in 92.6% of the patients.
Asunto(s)
Enfermedades del Conducto Colédoco/cirugía , Descompresión/métodos , Dolor Postoperatorio , Pancreatectomía , Pancreatoyeyunostomía , Pancreatitis Crónica , Dolor Abdominal/etiología , Dolor Abdominal/fisiopatología , Adulto , Pérdida de Sangre Quirúrgica/prevención & control , Enfermedades del Conducto Colédoco/etiología , Enfermedades del Conducto Colédoco/fisiopatología , Femenino , Hemostasis Quirúrgica/métodos , Humanos , Masculino , Persona de Mediana Edad , Dimensión del Dolor/métodos , Dolor Postoperatorio/etiología , Dolor Postoperatorio/fisiopatología , Pancreatectomía/efectos adversos , Pancreatectomía/métodos , Pancreatoyeyunostomía/efectos adversos , Pancreatoyeyunostomía/métodos , Pancreatitis Crónica/complicaciones , Pancreatitis Crónica/fisiopatología , Pancreatitis Crónica/cirugía , Satisfacción del Paciente , Calidad de Vida , Encuestas y Cuestionarios , Resultado del TratamientoRESUMEN
Results of 18 patients with traumatic diaphragmal hernia treatment were generalized. Most of them were hospitalized at a date later than 1 year after injury for the other diseases, at 4--diagnosis was established during the operation. Operated in conditions of partial or complete strangulated hernia 16 patients. A critical analysis of diagnostic methods and options of surgical tactics in traumatic diaphragmatic hernia was lead. Based algorhythm for choosing the adequate surgical access.
Asunto(s)
Hernia Diafragmática Traumática/cirugía , Laparoscopía/métodos , Traumatismos Torácicos/complicaciones , Procedimientos Quirúrgicos Torácicos/métodos , Traumatismos Abdominales/complicaciones , Traumatismos Abdominales/diagnóstico por imagen , Adulto , Femenino , Hernia Diafragmática Traumática/diagnóstico por imagen , Humanos , Masculino , Radiografía , Estudios Retrospectivos , Traumatismos Torácicos/diagnóstico por imagen , Factores de Tiempo , Resultado del Tratamiento , UltrasonografíaRESUMEN
Retro- and prospective investigation of the diagnosis and treatment results of 6 patients, suffering intraductal papillary-mucinous neoplasms (IPMN), was conducted. In 2 patients the central type malignant IPMN were diagnosed, in 1 - the central type of IPMN without malignization signs, in 2 - the IPMN of lateral type without malignization signs, in 1 - the multiple malignized IPMN of lateral type. The magnet resonance cholangiopancreatography, permitted to determine the pancreatic ductal system tumoral involvement, had constituted the main method of instrumental diagnosis. Radical operation was performed in 4 patients (in 3 - pancreatoduodenal resection, in 1 - subtotal distal pancreatic resection), in 2 - palliative operations. Follow-up in radically operated patients in terms from 6 to 21 months showed no recurrence of the disease.
Asunto(s)
Adenocarcinoma Mucinoso/cirugía , Carcinoma Ductal Pancreático/cirugía , Carcinoma Papilar/cirugía , Adenocarcinoma Mucinoso/diagnóstico , Adenocarcinoma Mucinoso/patología , Carcinoma Ductal Pancreático/diagnóstico , Carcinoma Ductal Pancreático/patología , Carcinoma Papilar/diagnóstico , Carcinoma Papilar/patología , Pancreatocolangiografía por Resonancia Magnética , Diagnóstico Diferencial , Humanos , Inmunohistoquímica , Pancreatectomía , Pancreaticoduodenectomía , Estudios Prospectivos , Estudios Retrospectivos , Resultado del TratamientoRESUMEN
Results of selective analysis of examination and operative treatment data in patients with clinical diagnosis of cystic pancreatic tumour for ten-year period were presented. The causes of diagnostic and tactic mistakes were analyzed. The volume of necessary methods of instrumental and laboratory diagnosis, indications for operative treatment, volume of which depends on the tumour morphological characteristic, were determined. In serous cystadenoma the tumour excision or economic pancreatic resection is indicated; in mucinous tumour the extended pancreatic resection is indicated.
Asunto(s)
Cistadenocarcinoma/diagnóstico , Cistadenocarcinoma/cirugía , Cistoadenoma/diagnóstico , Cistoadenoma/cirugía , Neoplasias Pancreáticas/diagnóstico , Neoplasias Pancreáticas/cirugía , Adulto , Anciano , Cistadenocarcinoma/diagnóstico por imagen , Cistadenocarcinoma/patología , Diagnóstico Diferencial , Femenino , Humanos , Masculino , Registros Médicos , Persona de Mediana Edad , Pancreatectomía , Neoplasias Pancreáticas/diagnóstico por imagen , Neoplasias Pancreáticas/patología , Pancreaticoduodenectomía , Esplenectomía , UltrasonografíaRESUMEN
The peculiarities of the cystic pancreatic tumor morphogenesis were studied up. Possibility and probability of the anastomosis existence between mucinous cystic tumor and pancreatic duct with its secondary mucinous dilatation were confirmed, causing the complications occurrence, an acute pancreatitis in particular. Selecting the surgical tactic in mucinous cystic tumor it is necessary to take into account the probability of the intraductal malignization foci formation, what precludes application of extended pancreatic resection using adjuvant chemotherapy and the postoperative serological control conduction.
Asunto(s)
Cistadenocarcinoma Mucinoso/complicaciones , Neoplasias Pancreáticas/complicaciones , Pancreatitis Aguda Necrotizante/etiología , Anciano , Cistadenocarcinoma Mucinoso/patología , Cistadenocarcinoma Mucinoso/cirugía , Femenino , Humanos , Persona de Mediana Edad , Pancreatectomía , Neoplasias Pancreáticas/patología , Neoplasias Pancreáticas/cirugía , Pancreatitis Aguda Necrotizante/patología , Pancreatitis Aguda Necrotizante/cirugía , Resultado del TratamientoRESUMEN
Data are presented on the reversibility of pathological changes of the common bile duct, causes and criteria of reversibility. Consideration of four stages of pathomorphogenesis of the common bile duct wall may be of help in the choice of surgical tactics in surgical intervention on the common bile duct.
Asunto(s)
Colestasis/patología , Conducto Colédoco/patología , Biopsia , Coledocostomía , Colestasis/etiología , Colestasis/cirugía , Conducto Colédoco/cirugía , Humanos , Microscopía Electrónica de Rastreo , Membrana Mucosa/ultraestructuraRESUMEN
The authors have developed a new method for intraoperative hemostasis in parenchymatous hemorrhage. Hemostasis is achieved by means of electrophoresis of fibrinogen and some other factors of blood coagulation into the organ parenchyma. Approbation of the method on dogs has demonstrated its atraumaticity and safety.
Asunto(s)
Pérdida de Sangre Quirúrgica/prevención & control , Fibrinógeno/uso terapéutico , Hemostasis Quirúrgica/métodos , Animales , Perros , Electroforesis , Femenino , Cuidados Intraoperatorios , MasculinoRESUMEN
The authors have developed a prompt and informative method for assessment of the depth and reversibility of the morphofunctional changes in the common bile duct (CBD) wall with the use of staining by hematoxylin basic, fuchsin-picric acid. Four types of the morphologic changes in CBD wall, which characterize the different degree of reversibility, were established. Depending of presence of these types, the corresponding surgical tactics is recommended.