Danilov M V, Glabaĭ V P, Gavrilin A V
Khirurgiia (Mosk). 2003(3):64-8.
Experience in the treatment of 1498 patients with alcoholic pancreatitis treated with laparotomic and mini-invasive surgeries both in acute and chronic phases of the disease is presented. In 742 patients surgical treatment was multistaged. Re-operations in 17 patients with "chronic purulent pancreatitis", reconstructive surgeries on the pancreas, pancreatic and bile ducts in 84 patients with "head" pancreatitis were most difficult. Percutaneous puncture-catheter procedures for liquid formations in acute phase of pancreatitis were effective as the first stage of treatment to reduce the danger of subsequent laparotomy. Catheterisation of chronic pseudocysts in alcoholic pancreatitis is associated with frequent complications and recurrences and can not be regarded as alternative to internal drainage surgeries. Pancreatic surgeries must guarantee effective correction of intrapancreatic hypertension for prevention of acute pancreatitis recurrences. In acute phase of pancreatitis surgical methods must ensure prevention of symptoms recurrences and pyoseptic complications of pancreatitis.
本文介绍了1498例酒精性胰腺炎患者在疾病急性期和慢性期接受剖腹手术和微创手术治疗的经验。742例患者接受了多阶段手术治疗。17例“慢性化脓性胰腺炎”患者的再次手术、84例“头部”胰腺炎患者的胰腺、胰管和胆管重建手术最为困难。胰腺炎急性期针对液体形成的经皮穿刺置管操作作为治疗的第一阶段，可有效降低后续剖腹手术的风险。酒精性胰腺炎慢性假性囊肿的置管引流常伴有并发症和复发，不能替代内引流手术。胰腺手术必须保证有效纠正胰腺内高压，以预防胰腺炎复发。在胰腺炎急性期，手术方法必须确保预防胰腺炎症状复发和脓性并发症。
