Shalimov A A, Shalimov S A, Lifshits Iu Z, Kozhara S P, Usenko A Iu
Klin Khir (1962). 1989(11):1-5.
The analysis of the 10-year experience with surgical treatment of 719 patients with chronic pancreatitis is presented. Of them in 461, the direct interventions on the pancreas were performed. Drainage operations were performed in 270 patients, the lethality was 3.3%, different modifications of pancreatic resection were used in 191 patients, the lethality was 8.3%. Together with the recognized interventions, the new ones--recanalization of the pancreatic duct with plasty of its wall, recanalization of the pancreatic duct by the small intestinal segment, anatomical resection of the pancreatic head were performed. The main requirements for the performance of pancreatic resection in patients with chronic pancreatitis were defined: resection within the limits of the irreversibly changed area of a gland; choice of a method for stump management with regard to functional state of a gland; restoration of physiologic pathways for passage of the food, bile and pancreatic secret. The surgical principles permitting to improve carbohydrate metabolism in patients after pancreatoduodenal resection have been developed.
本文介绍了对719例慢性胰腺炎患者进行手术治疗的10年经验分析。其中461例患者对胰腺进行了直接干预。270例患者进行了引流手术，死亡率为3.3%；191例患者采用了不同术式的胰腺切除术，死亡率为8.3%。除了公认的手术方式外，还开展了新的手术：胰管再通并进行管壁成形术、利用小肠段进行胰管再通、胰头解剖切除术。明确了慢性胰腺炎患者实施胰腺切除术的主要要求：在胰腺不可逆病变区域内进行切除；根据胰腺功能状态选择残端处理方法；恢复食物、胆汁和胰液的生理通道。已经制定了能改善胰十二指肠切除术后患者碳水化合物代谢的手术原则。
