RESUMEN
Extraperitoneal, transperitoneal and combined peritoneostomy was used in 29 patients with acute pancreonecrosis and predominant damage of retroperitoneal fat. The choice of surgical method depended of the volume of damage of pancreas and retroperitoneal fat. The wide opening of necrotized zones of retroperitoneal fat, removal of necrotized tissues and adequate drainage can stop further spreading of suppuration of the retroperitoneal fat. The mortality rate was 6/29 (20.7%).
Asunto(s)
Pancreatitis Aguda Necrotizante/cirugía , Espacio Retroperitoneal/cirugía , Adulto , Anciano , Drenaje , Femenino , Humanos , Masculino , Métodos , Persona de Mediana Edad , Pancreatitis Aguda Necrotizante/etiología , Pancreatitis Aguda Necrotizante/mortalidad , Pancreatitis Alcohólica/etiología , Pancreatitis Alcohólica/mortalidad , Pancreatitis Alcohólica/cirugíaRESUMEN
The article analyses experience accumulated since September 1988 by the Department of Vascular Surgery based on Nizhny Novgorod Regional Clinical Hospital. The Department is equipped with apparatuses by means of which patients with generalized atherosclerotic lesions of the aorta and its branches can be examined to a full measure. The authors performed 287 operations on 205 patients with 3.9% mortality. The tactics of surgical treatment of patients with various atherosclerotic lesions of the aorta and its branches are analysed. It is concluded that multistage correction of the blood flow is most optimal in such patients.
Asunto(s)
Enfermedades de la Aorta/cirugía , Arteriosclerosis/cirugía , Aorta Abdominal , Aorta Torácica , Enfermedades de la Aorta/complicaciones , Enfermedades de la Aorta/mortalidad , Enfermedades de la Aorta/fisiopatología , Arteriosclerosis/complicaciones , Arteriosclerosis/mortalidad , Arteriosclerosis/fisiopatología , Humanos , Factores de Riesgo , Procedimientos Quirúrgicos Vasculares/métodos , Procedimientos Quirúrgicos Vasculares/mortalidadRESUMEN
The results of surgical treatment are analysed on the basis of experience in 131 operations on the pancreas in pancreonecrosis (81 resections of the pancreas, 28 operations for drainage of the cyst in the acute stage, 22 operations for necr- and sequestrectomy). The indications for various types of intervention according to the destruction of the pancreas and the stage of the process are determined. Twenty-one patients died after the operation.
Asunto(s)
Enfermedades Pancreáticas/cirugía , Adulto , Anciano , Anciano de 80 o más Años , Drenaje , Femenino , Humanos , Masculino , Persona de Mediana Edad , Necrosis , Páncreas/patología , Pancreatectomía , Quiste Pancreático/cirugía , Enfermedades Pancreáticas/patología , Pancreatitis/cirugíaRESUMEN
The author analysed the results of pancreonecrosis management in 23 patients who were subjected to necrectomy and sequestrectomy. Necrectomy was conducted in three variants according to the depth at which the necrotic focus was found in the parenchyma of the pancreas. The best results were produced in patients with solitary foci of necrosis who were operated on the second week of the disease. Sequestration fo the pancreas was diagnosed from the clinical picture, scanning of the pancreas and angiography were performed. Sequestration is a technologically difficult operation which is fraught with the development of many complications, its success depends on the radical character of the removal of all sequestered areas and adequate drainage.