ABSTRACT
Remote results of surgical treatment of patients, suffering locally spread forms of pancreatic malignancies (PM), using different approaches, were analyzed. In retrospective investigation were included 84 patients with PM and invasion of the main vessels. In the group Ð patients palliative operations were performed, including in a subgroup Ðа cryoablation of PM, in a subgroup Ðb palliative pancreatic resection with leaving the tumor on the main vessels intact; and in patients of group ÐÐ the tumor was resected radically, including in a sub* group ÐÐаpancreatic resection or total pancreatectomy with resection of the main vessels, and in subgroup ÐÐb pancreatic resection or total pancreatectomy with cryoablation of tumor, which was left on the main vessel. The oneyear, threeyears and fiveyears survival indices have constituted in a subgroup Ðа, accordingly 74, 17 and 0% (survival median 16 mo); in a subgroup Ðb 70, 20 and 0% (survival median 20 mo); in a subgroup ÐÐа 83, 49 and 21% (survival median 29 mo); in a subgroup ÐÐb 73, 41 and 18% (survival median 26 mo). Difference between the general survival indices in subgroups Ðа and ÐÐа, Ðb and ÐÐа is statistically significant. Application of aggressive surgical tactics have permitted to improve the general survival indices of the patients.
Subject(s)
Carcinoma, Pancreatic Ductal/surgery , Cryosurgery/methods , Palliative Care/methods , Pancreas/surgery , Pancreatectomy/methods , Pancreatic Neoplasms/surgery , Aged , Carcinoma, Pancreatic Ductal/blood supply , Carcinoma, Pancreatic Ductal/mortality , Carcinoma, Pancreatic Ductal/pathology , Female , Humans , Male , Middle Aged , Pancreas/blood supply , Pancreas/pathology , Pancreatectomy/classification , Pancreatic Neoplasms/blood supply , Pancreatic Neoplasms/mortality , Pancreatic Neoplasms/pathology , Retrospective Studies , Survival AnalysisABSTRACT
In 2015 yr еndoscopic transpapillary interventions (ÐТI), performed for diseases of the hepatopancreatoduodenal zone organs, were done in 697 patients. In 315 (45.2%) of them ÐТI were diagnostic, in 382 (54.8%) performed with treatment objective. Ðеdicinal support for the ÐТI conduction in 631 (90.5%) patients have included conduction of superficial sedation and local anesthesia of pharynx. Ðnesthesiological support was applied in 66 (9.5%) patients, including total intravenous anesthesia in 11 (16.6%), еndotracheal narcosis in 55 (83.4%). Using of general anesthesia in comparison to superficial sedation creates more favorable conditions for the ÐТI performance, what have permitted to reduce their duration and complications rate twice.