Pub Date : 2022-09-20DOI: 10.16931/1995-5464.2022-3-100-107
M. N. Kaminskiy, S. N. Kachalov, D. Ivanov, S. N. Rakhimova
Gastric stasis constitutes a common complication of pancreaticoduodenal resection, which is insufficiently covered in Russian literature. The paper considers issues pertaining to terminology and the current classification of gastric stasis. The possibilities of preventing this complication are discussed from the perspective of evidence-based medicine.
{"title":"Gastric stasis following pancreatoduodenal resection: terminology and prevention issues","authors":"M. N. Kaminskiy, S. N. Kachalov, D. Ivanov, S. N. Rakhimova","doi":"10.16931/1995-5464.2022-3-100-107","DOIUrl":"https://doi.org/10.16931/1995-5464.2022-3-100-107","url":null,"abstract":"Gastric stasis constitutes a common complication of pancreaticoduodenal resection, which is insufficiently covered in Russian literature. The paper considers issues pertaining to terminology and the current classification of gastric stasis. The possibilities of preventing this complication are discussed from the perspective of evidence-based medicine.","PeriodicalId":36549,"journal":{"name":"Annals of HPB Surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44795814","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-09-20DOI: 10.16931/1995-5464.2022-3-74-80
A. D. Kovalevskii, M. Prudkov
Aim. To demonstrate our own experience of performing transfistula cholangioscopy and removing bile duct stones.Materials and Methods. From 2017 to 2019, 230 patients with functioning external biliary drains underwent antegrade transfistula cholangioscopy. Preliminary dilatation and straightening of the fistulous tract were required in 37 patients.Results. Bile duct stones were detected in 158 (68.7%) patients. During transfistula cholangioscopy, stones were removed from all patients. In 68 cases with large choledocholithiasis, it was necessary to perform contact lithotripsy. To this end, staged treatment and two hospitalizations were required in five cases. Adequate transfistular access to the bile ducts was formed during the first hospital stay; during the second, after hardening of the access walls, the stones were removed. The overall complication rate was 3.8%, including grade III–IV complications (1.9%) according to the Clavien–Dindo classification. Mortality was 0.4%.Conclusion. Transfistula cholangioscopy increases the reliability of stone detection in the bile ducts, permits removing them without mandatory dissection of the major duodenal papilla, and creates favorable conditions for a more accurate assessment of its functional state. When patients with functioning biliary drains and unresolved bile duct diseases are placed in a specialized medical center, they can be provided with high-quality care. Additionally, it creates rational conditions for the use of the highly effective methods of endobiliary diagnosis and treatment.
{"title":"Transfistula cholangioscopy: clarification of the diagnosis and antegrade removal of residual bile duct stones","authors":"A. D. Kovalevskii, M. Prudkov","doi":"10.16931/1995-5464.2022-3-74-80","DOIUrl":"https://doi.org/10.16931/1995-5464.2022-3-74-80","url":null,"abstract":"Aim. To demonstrate our own experience of performing transfistula cholangioscopy and removing bile duct stones.Materials and Methods. From 2017 to 2019, 230 patients with functioning external biliary drains underwent antegrade transfistula cholangioscopy. Preliminary dilatation and straightening of the fistulous tract were required in 37 patients.Results. Bile duct stones were detected in 158 (68.7%) patients. During transfistula cholangioscopy, stones were removed from all patients. In 68 cases with large choledocholithiasis, it was necessary to perform contact lithotripsy. To this end, staged treatment and two hospitalizations were required in five cases. Adequate transfistular access to the bile ducts was formed during the first hospital stay; during the second, after hardening of the access walls, the stones were removed. The overall complication rate was 3.8%, including grade III–IV complications (1.9%) according to the Clavien–Dindo classification. Mortality was 0.4%.Conclusion. Transfistula cholangioscopy increases the reliability of stone detection in the bile ducts, permits removing them without mandatory dissection of the major duodenal papilla, and creates favorable conditions for a more accurate assessment of its functional state. When patients with functioning biliary drains and unresolved bile duct diseases are placed in a specialized medical center, they can be provided with high-quality care. Additionally, it creates rational conditions for the use of the highly effective methods of endobiliary diagnosis and treatment.","PeriodicalId":36549,"journal":{"name":"Annals of HPB Surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47054545","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-09-20DOI: 10.16931/1995-5464.2022-3-55-62
A. Kriger, D. Gorin, A. Pavlov, N. Pronin, D. Sidorov, A. Kaldarov, K. E. Ponezhev, V. Panteleev
Aim. To study the specific features of the splenic artery architectonics and evaluate the results of distal pancreatic resection for various tumors.Materials and Methods. In the anatomical part, we examined 88 organ complexes taken from people whose death was not associated with diseases of the abdominal organs. We studied the topography of the splenic artery and the dependence of the number of its branches to the pancreas on the vessel tortuosity. The clinical part of the study presents the results of 122 distal resections performed during 2016-2021. 79 operations were carried out using the traditional method, 32 operations were robot-assisted, and 11 were performed laparoscopically.Results. The research found a relationship between the degree of the splenic artery tortuosity and the number of branches to the pancreas, which varies from three to nine. Out of the 122 operated patients, in 24 (19.7%) cases a clinically relevant (type B) pancreatic fistula that required additional treatment was formed. Intra-abdominal bleeding developed in 15 (12.3%) patients: early – in 10, late arrosive hemorrhage associated with a pancreatic fistula – in 5 cases. One (0.8%) patient died.Conclusion. It is necessary to consider the architectonics of the splenic artery during distal pancreatic resection. The frequency of pancreatic fistula formation does not depend on the method of performing the operation. Of the prognostic factors, the body mass index is statistically significant. Late arrosive bleeding develops against the background of a clinically relevant pancreatic fistula.
{"title":"Distal resection for pancreatic tumors","authors":"A. Kriger, D. Gorin, A. Pavlov, N. Pronin, D. Sidorov, A. Kaldarov, K. E. Ponezhev, V. Panteleev","doi":"10.16931/1995-5464.2022-3-55-62","DOIUrl":"https://doi.org/10.16931/1995-5464.2022-3-55-62","url":null,"abstract":"Aim. To study the specific features of the splenic artery architectonics and evaluate the results of distal pancreatic resection for various tumors.Materials and Methods. In the anatomical part, we examined 88 organ complexes taken from people whose death was not associated with diseases of the abdominal organs. We studied the topography of the splenic artery and the dependence of the number of its branches to the pancreas on the vessel tortuosity. The clinical part of the study presents the results of 122 distal resections performed during 2016-2021. 79 operations were carried out using the traditional method, 32 operations were robot-assisted, and 11 were performed laparoscopically.Results. The research found a relationship between the degree of the splenic artery tortuosity and the number of branches to the pancreas, which varies from three to nine. Out of the 122 operated patients, in 24 (19.7%) cases a clinically relevant (type B) pancreatic fistula that required additional treatment was formed. Intra-abdominal bleeding developed in 15 (12.3%) patients: early – in 10, late arrosive hemorrhage associated with a pancreatic fistula – in 5 cases. One (0.8%) patient died.Conclusion. It is necessary to consider the architectonics of the splenic artery during distal pancreatic resection. The frequency of pancreatic fistula formation does not depend on the method of performing the operation. Of the prognostic factors, the body mass index is statistically significant. Late arrosive bleeding develops against the background of a clinically relevant pancreatic fistula.","PeriodicalId":36549,"journal":{"name":"Annals of HPB Surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49448035","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-09-20DOI: 10.16931/1995-5464.2022-3-68-73
N. Burlov, G. Khrykov, E. A. Burlova, K. Shostka
Aim. To evaluate the effectiveness of the PREPARE score in predicting severe complications after pancreatic surgery.Materials and Methods. The case-control study included patients operated on the pancreas. Grade ≥III Clavien– Dindo complications were designated as “severe”. Patients were divided into two groups: “0–II degree” (control) and “III–V degree” (case). For all patients, scores were calculated, and risk categories were determined according to the PREPARE score.Results. The study included 151 patients: “0–II degree” – 102 (68%) observations, “III–V degree” – 49 (32%). ROC analysis was used for the scores (AUC = 0.616; 95% CI 0.527–0.706; p = 0.014) and for the risk categories (AUC = 0.555; 95% CI 0.463–0.648; p = 0.241) of the PREPARE score.Conclusion. The obtained data do not currently enable us to recommend the PREPARE score for predicting complications of pancreatic surgery.
的目标。目的:评价PREPARE评分预测胰腺手术后严重并发症的有效性。材料与方法。病例对照研究包括胰腺手术的患者。≥III级Clavien - Dindo并发症为“严重”。患者分为“0-II度”组(对照)和“III-V度”组(病例)。对所有患者计算评分，并根据PREPARE评分确定风险类别。该研究包括151例患者:“0-II度”- 102例(68%)，“III-V度”- 49例(32%)。采用ROC分析(AUC = 0.616;95% ci 0.527-0.706;p = 0.014)，风险类别(AUC = 0.555;95% ci 0.463-0.648;p = 0.241)。目前获得的数据不能使我们推荐PREPARE评分来预测胰腺手术并发症。
{"title":"Prediction of severe postoperative complications in pancreatic surgery using the Preoperative Pancreatic Resection (PREPARE) score: a single-center observational study","authors":"N. Burlov, G. Khrykov, E. A. Burlova, K. Shostka","doi":"10.16931/1995-5464.2022-3-68-73","DOIUrl":"https://doi.org/10.16931/1995-5464.2022-3-68-73","url":null,"abstract":"Aim. To evaluate the effectiveness of the PREPARE score in predicting severe complications after pancreatic surgery.Materials and Methods. The case-control study included patients operated on the pancreas. Grade ≥III Clavien– Dindo complications were designated as “severe”. Patients were divided into two groups: “0–II degree” (control) and “III–V degree” (case). For all patients, scores were calculated, and risk categories were determined according to the PREPARE score.Results. The study included 151 patients: “0–II degree” – 102 (68%) observations, “III–V degree” – 49 (32%). ROC analysis was used for the scores (AUC = 0.616; 95% CI 0.527–0.706; p = 0.014) and for the risk categories (AUC = 0.555; 95% CI 0.463–0.648; p = 0.241) of the PREPARE score.Conclusion. The obtained data do not currently enable us to recommend the PREPARE score for predicting complications of pancreatic surgery.","PeriodicalId":36549,"journal":{"name":"Annals of HPB Surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44878193","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-09-15DOI: 10.16931/1995-5464.2022-3-114-125
E. Galperin
Despite the deep understanding of the importance of energy supply in the development of the vast majority of processes and phenomena in organism, there are practically no conceptual researches of energy requirements in severe diseases, traumatic injuries, stressful effects and related treatment in the medical literature.The proposed hypothesis is based on the analysis of literature data (PubMed keywords: energy deficit, stressor, metabolic stress, ATP, gluconeogenesis, oxidative phosphorylation, mitochondria, insulin secretion), reconsideration of the results of our experiments dedicated to the energetic statement of liver tissue in obstructive jaundice (OJ), ischemia and massive resection, summarization of 60 years of experience in clinical, surgical and scientific activities, which made it possible to make a number of assumptions that need further clinical and experimental verification.Various pathogens (stressors) cause the additional energy production in the body, which is the energy basis of metabolic responses that ensure the adaptation of the body's vital functions and the elimination of the pathogen by activation of innate immunity, systemic inflammatory reaction, activation of the sympathetic nervous system, etc.Additional energy is the integral strength of the response to the pathogen, that takes into consideration with the strength of the stressor and the individual strength of the body's response, which can be different for the same strength of the stressor. In fact, when stress develops, it determines its strength in digital form, i.e. in real view.The concept of this hypothesis comes from the fact that stress, which main task is to provide the energy of organism, appears when there is a certain level of energy deficiency in the body.Such level rarely appears immediately after the action of the stressor. At the beginning, pre-stress adaptive reactions usually occur, which use the energy reserve in cells in the form of ATP and glycogen, and are also the result of energy redistribution: a decrease in it in insulin-dependent tissues and an increase in insulin-independent ones, which include vital organs.This made it possible to divide metabolic responses into two groups: pre-stress and stress, and to distinguish two periods: “pre-stress” and “metabolic stress”. Pre-stress reactions, in our opinion, are also aimed at preventing the development of metabolic stress, which generates energy through proteolysis and lipolysis of body tissues. Metabolic stress develops when pre-stress reactions cannot satisfy the needs of the body and a certain, expressed in numerical value, energy deficit occurs. In a certain extent the metabolic situation in the body reflects by the liver, which is a metabolic organ that performs many reactions both during normal and stressful metabolism, generates ATP energy, and takes into account the metabolic state of other organs. The level of energy deficiency of the liver tissue can be an indicator that causes the form
{"title":"Energetic insufficiency of liver tissue and additional energy in digital value. (The hypothesis)","authors":"E. Galperin","doi":"10.16931/1995-5464.2022-3-114-125","DOIUrl":"https://doi.org/10.16931/1995-5464.2022-3-114-125","url":null,"abstract":"Despite the deep understanding of the importance of energy supply in the development of the vast majority of processes and phenomena in organism, there are practically no conceptual researches of energy requirements in severe diseases, traumatic injuries, stressful effects and related treatment in the medical literature.The proposed hypothesis is based on the analysis of literature data (PubMed keywords: energy deficit, stressor, metabolic stress, ATP, gluconeogenesis, oxidative phosphorylation, mitochondria, insulin secretion), reconsideration of the results of our experiments dedicated to the energetic statement of liver tissue in obstructive jaundice (OJ), ischemia and massive resection, summarization of 60 years of experience in clinical, surgical and scientific activities, which made it possible to make a number of assumptions that need further clinical and experimental verification.Various pathogens (stressors) cause the additional energy production in the body, which is the energy basis of metabolic responses that ensure the adaptation of the body's vital functions and the elimination of the pathogen by activation of innate immunity, systemic inflammatory reaction, activation of the sympathetic nervous system, etc.Additional energy is the integral strength of the response to the pathogen, that takes into consideration with the strength of the stressor and the individual strength of the body's response, which can be different for the same strength of the stressor. In fact, when stress develops, it determines its strength in digital form, i.e. in real view.The concept of this hypothesis comes from the fact that stress, which main task is to provide the energy of organism, appears when there is a certain level of energy deficiency in the body.Such level rarely appears immediately after the action of the stressor. At the beginning, pre-stress adaptive reactions usually occur, which use the energy reserve in cells in the form of ATP and glycogen, and are also the result of energy redistribution: a decrease in it in insulin-dependent tissues and an increase in insulin-independent ones, which include vital organs.This made it possible to divide metabolic responses into two groups: pre-stress and stress, and to distinguish two periods: “pre-stress” and “metabolic stress”. Pre-stress reactions, in our opinion, are also aimed at preventing the development of metabolic stress, which generates energy through proteolysis and lipolysis of body tissues. Metabolic stress develops when pre-stress reactions cannot satisfy the needs of the body and a certain, expressed in numerical value, energy deficit occurs. In a certain extent the metabolic situation in the body reflects by the liver, which is a metabolic organ that performs many reactions both during normal and stressful metabolism, generates ATP energy, and takes into account the metabolic state of other organs. The level of energy deficiency of the liver tissue can be an indicator that causes the form","PeriodicalId":36549,"journal":{"name":"Annals of HPB Surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46541126","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-06-07DOI: 10.16931/10.16931/1995-5464.2022-2-73-81
S. Remizov, A. Andreev, V. M. Durleshter, S. A. Gabriel’, F. K. Akhidzhak
Aim. To improve the efficacy of minimally invasive surgical treatment for infected pancreatic necrosis.Materials and methods. The study analyzed the data of 142 patients with moderate to severe infected pancreatic necrosis treated from 2012 to 2017. In 2012–2014, an incision and drainage procedure involving multiple drainage replacements and debridements was used in 84 (59.2%) patients comprising Group 1. Since 2015, 58 (40.8%) patients comprising Group 2 have been treated using large-diameter (30–32 Fr) tube drainage followed by debridement and transfistula videoscopic necrosequestrectomy.Results. The best results were obtained by draining pathological cavities using large-diameter double-lumen drainage, as well as by actively removing sequestra using the developed technique of transfistula videoscopic necrosequestrectomy. In Group 2, the incidence of local complications amounted to 6.8% as compared to 22.6% in Group 1. Group 2 exhibited significantly lower case mortality rate (12.3% and 19.4%; t = 2.1; p ≤ 0.05), while patients in Group 1 required longer hospitalization: 96 ± 7.4 days as compared to 71 ± 3.2 days in Group 2 (t = 2.9 p ≤ 0.05).Conclusion. Minimally invasive procedures involving transfistula videoscopic necrosequestrectomy improve treatment outcomes, as well as reducing case mortality rate in the setting of purulent-necrotic parapancreatitis.
{"title":"Results of using transfistula videoscopic necrosequestrectomy to treat purulent-necrotic parapancreatitis","authors":"S. Remizov, A. Andreev, V. M. Durleshter, S. A. Gabriel’, F. K. Akhidzhak","doi":"10.16931/10.16931/1995-5464.2022-2-73-81","DOIUrl":"https://doi.org/10.16931/10.16931/1995-5464.2022-2-73-81","url":null,"abstract":"Aim. To improve the efficacy of minimally invasive surgical treatment for infected pancreatic necrosis.Materials and methods. The study analyzed the data of 142 patients with moderate to severe infected pancreatic necrosis treated from 2012 to 2017. In 2012–2014, an incision and drainage procedure involving multiple drainage replacements and debridements was used in 84 (59.2%) patients comprising Group 1. Since 2015, 58 (40.8%) patients comprising Group 2 have been treated using large-diameter (30–32 Fr) tube drainage followed by debridement and transfistula videoscopic necrosequestrectomy.Results. The best results were obtained by draining pathological cavities using large-diameter double-lumen drainage, as well as by actively removing sequestra using the developed technique of transfistula videoscopic necrosequestrectomy. In Group 2, the incidence of local complications amounted to 6.8% as compared to 22.6% in Group 1. Group 2 exhibited significantly lower case mortality rate (12.3% and 19.4%; t = 2.1; p ≤ 0.05), while patients in Group 1 required longer hospitalization: 96 ± 7.4 days as compared to 71 ± 3.2 days in Group 2 (t = 2.9 p ≤ 0.05).Conclusion. Minimally invasive procedures involving transfistula videoscopic necrosequestrectomy improve treatment outcomes, as well as reducing case mortality rate in the setting of purulent-necrotic parapancreatitis.","PeriodicalId":36549,"journal":{"name":"Annals of HPB Surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49457781","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-06-07DOI: 10.16931/1995-5464.2022-2-108-114
S. Grigorev, A. V. Novozhilov, E. G. Grygoryev
The paper presents a clinical study of a 53-year-old patient who underwent liver transplantation complicated by proper hepatic artery thrombosis. No clinical or laboratory signs of the complication were observed. The disruption of arterial blood supply to the transplant was established on day six following surgery by means of routine Doppler ultrasound. Following successful selective endovascular thrombus aspiration and balloon dilation, the arterial blood flow was restored. However, one day later, the thrombosis recurred. Hepatic revascularization was achieved through thrombus re-aspiration and the proper hepatic artery stenting. In the subsequent postoperative period, no complications were observed. The paper analyzes possible causes of thrombosis and recurrent thrombosis, as well as reviewing modern literature.
{"title":"Recurrent thrombosis of liver transplant artery: diagnosis and staged minimally invasive treatment","authors":"S. Grigorev, A. V. Novozhilov, E. G. Grygoryev","doi":"10.16931/1995-5464.2022-2-108-114","DOIUrl":"https://doi.org/10.16931/1995-5464.2022-2-108-114","url":null,"abstract":"The paper presents a clinical study of a 53-year-old patient who underwent liver transplantation complicated by proper hepatic artery thrombosis. No clinical or laboratory signs of the complication were observed. The disruption of arterial blood supply to the transplant was established on day six following surgery by means of routine Doppler ultrasound. Following successful selective endovascular thrombus aspiration and balloon dilation, the arterial blood flow was restored. However, one day later, the thrombosis recurred. Hepatic revascularization was achieved through thrombus re-aspiration and the proper hepatic artery stenting. In the subsequent postoperative period, no complications were observed. The paper analyzes possible causes of thrombosis and recurrent thrombosis, as well as reviewing modern literature.","PeriodicalId":36549,"journal":{"name":"Annals of HPB Surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44058200","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-06-07DOI: 10.16931/1995-5464.2022-2-102-107
A. Kriger, N. Ratnikova, V. Panteleev, D. Gorin, A. Kaldarov, G. Karmazanovsky
Clinical observation of surgical treatment received by a patient with pancreatoblastoma is described. In the preoperative period, specialists had difficulties in determining the nature of the neoplasm, which led to some tactical complications. The patient underwent pancreaticoduodenal resection that involved resection of the pancreatic body, as well as the confluence of the superior mesenteric and splenic veins. The histologic and immunohistochemical studies confirmed the diagnosis of pancreatoblastoma. Therefore, the patient was referred for chemotherapeutic treatment.
{"title":"Difficulties in diagnosing pancreatoblastoma","authors":"A. Kriger, N. Ratnikova, V. Panteleev, D. Gorin, A. Kaldarov, G. Karmazanovsky","doi":"10.16931/1995-5464.2022-2-102-107","DOIUrl":"https://doi.org/10.16931/1995-5464.2022-2-102-107","url":null,"abstract":"Clinical observation of surgical treatment received by a patient with pancreatoblastoma is described. In the preoperative period, specialists had difficulties in determining the nature of the neoplasm, which led to some tactical complications. The patient underwent pancreaticoduodenal resection that involved resection of the pancreatic body, as well as the confluence of the superior mesenteric and splenic veins. The histologic and immunohistochemical studies confirmed the diagnosis of pancreatoblastoma. Therefore, the patient was referred for chemotherapeutic treatment.","PeriodicalId":36549,"journal":{"name":"Annals of HPB Surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42231232","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-06-07DOI: 10.16931/1995-5464.2022-2-65-72
I. M. Buriev, S. A. Grashchenko, L. V. Zhuravleva, A. E. Kotovskii, S. O. Shadskii, D. S. Kulikov, M. V. Guk
Aim. To evaluate the efficacy of endoscopic transpapillary pancreatic stenting in the prevention and combination therapy of acute pancreatitis.Materials and methods. The study examined 166 cases of pancreatic duct stenting intended to prevent acute postprocedural pancreatitis in 105 patients and to provide a combination therapy for acute pancreatitis in 61 patients. In this case plastic stents (3–7 Fr) were used that were removed on days 3–5 provided neither amylasemia nor clinical signs of acute pancreatitis were observed.Results. Pancreatic stenting performed to prevent acute post-procedural pancreatitis in 100 patients yielded good results in 95.2% of the cases; elective surgery was performed in 16 of these cases after 2 weeks. In 3.8% of the cases, some complications were observed (pancreatitis, jaundice); one (0.95%) fatal case was reported. In the combination therapy of severe pancreatitis (APACHE II >10 points), recovery was observed in 86.9% of the cases involving pancreatic duct stenting. In 11.3% of the cases, stenting was accompanied by minimally invasive surgical procedures. The disease was found to have progressed in 12 patients (19.7%). Four patients were discharged from the hospital with pancreatic fistulas, while 8 patients (13.1%) died.Conclusion. Preventive stenting of the pancreatic duct in the setting of complicated and atypical papillosphincterotomy reduces the incidence of acute pancreatitis to 3.8% at a case fatality rate of 0.95%. Pancreatic duct stenting is indicated for treatment of pancreatic necrosis in the setting of biliary pancreatitis involving impacted stones and severe acute pancreatitis at an amylase level of > 400 U/L during the first three days of the disease.
{"title":"Pancreatic stenting in the prevention and combination therapy of acute pancreatitis","authors":"I. M. Buriev, S. A. Grashchenko, L. V. Zhuravleva, A. E. Kotovskii, S. O. Shadskii, D. S. Kulikov, M. V. Guk","doi":"10.16931/1995-5464.2022-2-65-72","DOIUrl":"https://doi.org/10.16931/1995-5464.2022-2-65-72","url":null,"abstract":"Aim. To evaluate the efficacy of endoscopic transpapillary pancreatic stenting in the prevention and combination therapy of acute pancreatitis.Materials and methods. The study examined 166 cases of pancreatic duct stenting intended to prevent acute postprocedural pancreatitis in 105 patients and to provide a combination therapy for acute pancreatitis in 61 patients. In this case plastic stents (3–7 Fr) were used that were removed on days 3–5 provided neither amylasemia nor clinical signs of acute pancreatitis were observed.Results. Pancreatic stenting performed to prevent acute post-procedural pancreatitis in 100 patients yielded good results in 95.2% of the cases; elective surgery was performed in 16 of these cases after 2 weeks. In 3.8% of the cases, some complications were observed (pancreatitis, jaundice); one (0.95%) fatal case was reported. In the combination therapy of severe pancreatitis (APACHE II >10 points), recovery was observed in 86.9% of the cases involving pancreatic duct stenting. In 11.3% of the cases, stenting was accompanied by minimally invasive surgical procedures. The disease was found to have progressed in 12 patients (19.7%). Four patients were discharged from the hospital with pancreatic fistulas, while 8 patients (13.1%) died.Conclusion. Preventive stenting of the pancreatic duct in the setting of complicated and atypical papillosphincterotomy reduces the incidence of acute pancreatitis to 3.8% at a case fatality rate of 0.95%. Pancreatic duct stenting is indicated for treatment of pancreatic necrosis in the setting of biliary pancreatitis involving impacted stones and severe acute pancreatitis at an amylase level of > 400 U/L during the first three days of the disease.","PeriodicalId":36549,"journal":{"name":"Annals of HPB Surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42020177","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-06-07DOI: 10.16931/1995-5464.2022-2-31-38
F. Nazyrov, A. V. Devyatov, A. Babadjanov, U. Makhmudov, O. A. Omonov
Aim. To assess the clinical efficacy of preventing gastroesophageal bleeding in patients with liver cirrhosis.Materials and methods. From 2008 to 2019, the surgical treatment of 710 patients with cirrhosis was considered. The long-term results of preventing gastroesophageal variceal rebleeding were studied in three groups of patients: portosystemic shunt placement (367 patients), total esophagogastric disconnection (62 patients), and endoscopic procedures (281 patients). Observation periods varied from 1 to 115 months.Results. The lowest rebleeding rate of 15.5% was observed following shunt placement (χ2 = 9.728; df = 2; р = 0.008), while the highest rate of 40.9% was observed following endoscopic treatment. By the 5th year of follow-up, only 37.5% of patients showed no signs of bleeding following endoscopic procedures. The percentage of patients who did not experience true gastroesophageal variceal rebleeding amounted to 44%, 76%, and 85% following shunt placement, total esophagogastric disconnection, and endoscopic procedures, respectively (p < 0.05).Conclusion. Irrespective of the selected procedure, all patients with cirrhosis suffer from portal rebleeding in the longterm period. However, the lowest rebleeding rate is observed following portosystemic shunt placement.
{"title":"Efficacy of different methods for preventing gastroesophageal bleeding in patients with liver cirrhosis: comparative analysis","authors":"F. Nazyrov, A. V. Devyatov, A. Babadjanov, U. Makhmudov, O. A. Omonov","doi":"10.16931/1995-5464.2022-2-31-38","DOIUrl":"https://doi.org/10.16931/1995-5464.2022-2-31-38","url":null,"abstract":"Aim. To assess the clinical efficacy of preventing gastroesophageal bleeding in patients with liver cirrhosis.Materials and methods. From 2008 to 2019, the surgical treatment of 710 patients with cirrhosis was considered. The long-term results of preventing gastroesophageal variceal rebleeding were studied in three groups of patients: portosystemic shunt placement (367 patients), total esophagogastric disconnection (62 patients), and endoscopic procedures (281 patients). Observation periods varied from 1 to 115 months.Results. The lowest rebleeding rate of 15.5% was observed following shunt placement (χ2 = 9.728; df = 2; р = 0.008), while the highest rate of 40.9% was observed following endoscopic treatment. By the 5th year of follow-up, only 37.5% of patients showed no signs of bleeding following endoscopic procedures. The percentage of patients who did not experience true gastroesophageal variceal rebleeding amounted to 44%, 76%, and 85% following shunt placement, total esophagogastric disconnection, and endoscopic procedures, respectively (p < 0.05).Conclusion. Irrespective of the selected procedure, all patients with cirrhosis suffer from portal rebleeding in the longterm period. However, the lowest rebleeding rate is observed following portosystemic shunt placement.","PeriodicalId":36549,"journal":{"name":"Annals of HPB Surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42134421","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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