Long-term results after surgical treatment in patients suffering from chronic pancreatitis with signs of biliary hypertension

Authors

  • V. I. Pylypchuk Ivano-Frankivsk National Medical University, Ukraine,

DOI:

https://doi.org/10.14739/2310-1210.2018.5.141629

Keywords:

pancreatitis, biliary hypertension, portal pressure, magnetic resonance cholangiopancreatography, endoscopic retrograde cholangiopancreatography, mechanical jaundice

Abstract

The morbidity of chronic pancreatitis (CP) remains at a high level. Over the past thirty years, more than doubled growth in the number of patients with chronic pancreatitis has been noted.

Objective of our work is to study the long-term results after surgical treatment in patients suffering from CP with signs of biliary hypertension (BH) in order to justify adequate approaches to surgical treatment.

Materials and methods. The long-term results after surgical treatment in 163 patients suffering from CP with signs of BH were analyzed. The patients were divided into two groups: the group 1 (main) – 36 (22.1 %) patients, who underwent intraoperative monitoring of biliary pressure (IOM BP) for BH diagnostics; the group 2 (comparison group) – 127 (77.9 %) patients, who underwent common methods.

Results. Resection, drainage and palliative operations were performed in patients with CP and BH: resection surgeries – 95 (58.3 %) patients; draining surgeries – 44 (26.9 %) patients; palliative surgeries – 24 (14.8 %) patients. The long-term quality of life study after surgical interventions was conducted in 94 (57.6 %) patients. Good results were obtained in 25 (89.2 %) patients of the group 1 and in 45 (68.2 %) patients of the group 2; satisfactory – in 2 (7.1%) patients of the group 1 and in 17 (25.7 %) patients of the group 2; unsatisfactory – in 1 (3.6 %) patient of the group 1 and in 4 (6.1 %) patients of the group 2.

Conclusions. The proposed comprehensive diagnostic-therapeutic approach using the IOM BP method allowed obtaining good long-term results in 89.2 % of patients in the absence of BH recurrence. In the group of patients without BP monitoring the recurrent BH with mechanical jaundice manifestations appears significantly more often by 15.1 % (χ2 = 4.22, P = 0.04).

 

 

References

Kopchak, V. M., Kopchak, L. A., Pererva, L. A., & Duvalko, A. V. (2012) Khirurgicheskoe lechenie khronicheskogo pankreatita [Surgical treatment of chronic pancreatitis]. Zdorov'a Ukrainy, 18–19. [in Russian].

Yang C., Bliss L., Freedman S., Sheth, S., Chau Ng, S., Kent, T., et al. (2014). A single-center analysis of surgical treatment for chronic pacreatitis: relatively rare and unevenly deployed. Pancreatology, 14(3), 1, S40. doi: 10.1016/j.pan.2014.05.513.

D‘Haese, J. G., Cahen, D. L., & Werner, J. (2016). Current surgical treatment options in chronic pancreatitis. Pancreapedia: Exocrine Pancreas Knowledge Base. doi: 10.3998/panc.2016.26.

Strate, T., Taherpour, Z., Bloechle, C., Mann, O., Bruhn, J. P., Schneider, C., et al. (2005). Long-term follow-up of a randomized trial comparing the Beger and Frey procedures for patients suffering from chronic pancreatitis. Annals of Surgery, 241, 591–598. doi: 10.1097/01.sla.0000157268.78543.03.

Ho, H. S., & Frey, C. F. (2001). The Frey procedure: local resection of pancreatic head combined with lateral pancreaticojejunostomy. Archive Surgery, 136(12), 1353–1358. doi: 10.1001/archsurg.136.12.1353.

Pylypchuk, V. I., Kopchak, V. M., & Shevchuk, І. М. (2015) Patent №101713 Ukraina, MPK A 61V 17/00. Sposib khirurhichnoho likuvannia khronichnoho pankreatytu, uskladnenoho zhovchnokam’ianoiu khvoroboiu [Patent №101713 Ukraine, IPC A 61B 17/00. Method of surgical treatment of chronic pancreatitis complicated with cholelithiasis]. Biulleten, 18. [in Ukrainian].

Pylypchuk, V. I., Kopchak, V. M., & Shevchuk, І. М. (2016) Patent №109547 Україна, МПК А 61В 17/00 [Patent №109547 Ukraine, IPC A 61B 17/00, №2016 02279. Method of measuring the pressure in the common bile duct].; Biulleten, 16. [in Ukrainian].

Downloads

How to Cite

1.
Pylypchuk VI. Long-term results after surgical treatment in patients suffering from chronic pancreatitis with signs of biliary hypertension. Zaporozhye Medical Journal [Internet]. 2018Sep.24 [cited 2024Nov.5];(5). Available from: http://zmj.zsmu.edu.ua/article/view/141629

Issue

Section

Original research