RESUMEN
The results of laparoscopic treatment were analyzed in 9 patients, suffering pancreatic insulinoma, in the clinic in 2008-2012 yrs. Tumoral enucleation was performed in 6 patients, distal pancreatic resection--in 3. In 1 (11.1%) patient postoperative external pancreatic fistula have developed. All the patients are alive. Laparoscopic treatment of the patients, suffering insulinoma is effective and secure.
Asunto(s)
Hiperinsulinismo/etiología , Insulina/metabolismo , Insulinoma/cirugía , Laparoscopía/métodos , Neoplasias Pancreáticas/cirugía , Adulto , Endosonografía , Femenino , Humanos , Hiperinsulinismo/metabolismo , Hiperinsulinismo/cirugía , Secreción de Insulina , Insulinoma/complicaciones , Insulinoma/diagnóstico , Insulinoma/metabolismo , Imagen por Resonancia Magnética , Masculino , Neoplasias Pancreáticas/complicaciones , Neoplasias Pancreáticas/diagnóstico , Neoplasias Pancreáticas/metabolismo , Tomografía Computarizada Espiral , Resultado del TratamientoRESUMEN
The paper analyzes experience gained with the use of Sandostatin in patients with a surgical operation-induced pathology of pancreas. Sandostatin is known to be capable of suppressing the exocrine activity of pancreas, which fact made for decline in the recordable postoperative complications and improvement of results of surgical treatment. The maiden experience gained with its use showed high efficacy of Sandostatin in a multimodality treatment of patients presenting with surgical pathology of pancreas.
Asunto(s)
Antineoplásicos Hormonales/uso terapéutico , Insulinoma/tratamiento farmacológico , Octreótido/uso terapéutico , Neoplasias Pancreáticas/tratamiento farmacológico , Terapia Combinada , Evaluación de Medicamentos , Humanos , Insulinoma/cirugía , Páncreas/efectos de los fármacos , Páncreas/metabolismo , Neoplasias Pancreáticas/cirugía , Complicaciones Posoperatorias/prevención & controlAsunto(s)
Hiperinsulinismo/fisiopatología , Insulinoma/fisiopatología , Islotes Pancreáticos/fisiopatología , Neoplasias Pancreáticas/fisiopatología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Glucemia/análisis , Péptido C/sangre , Femenino , Glucagón/sangre , Humanos , Hiperinsulinismo/sangre , Insulina/sangre , Insulinoma/sangre , Masculino , Persona de Mediana Edad , Neoplasias Pancreáticas/sangre , RadioinmunoensayoAsunto(s)
Diabetes Mellitus Tipo 1/cirugía , Insulinoma , Trasplante de Islotes Pancreáticos , Neoplasias Pancreáticas , Animales , Glucemia/análisis , Diabetes Mellitus Experimental/sangre , Diabetes Mellitus Experimental/cirugía , Diabetes Mellitus Tipo 1/sangre , Estudios de Seguimiento , Humanos , Ratas , Factores de Tiempo , Células Tumorales CultivadasRESUMEN
New principle of choice of the surgical treatment method in patients with necrotic pancreatitis was proposed: different operative procedures don't compete one another but are applied in accordance with the disease stage in dynamics. Such tactics permits to choose an optimal surgical approach in every phase of pathologic process course. From 1989 till 1992 the surgical treatment for necrotic pancreatitis was conducted to 54 patients. Pancreatic resection was done to 14 (25.9%) of patients, 4 of whom died. In necrotic focus delimitation or pancreatic tissue sequestration, observed in terms of more than 2 weeks since the disease beginning, necrectomy was conducted in 40 (74.1%) of patients, 4 of whom died.
Asunto(s)
Pancreatitis/cirugía , Adolescente , Adulto , Anciano , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Necrosis , Páncreas/patología , Páncreas/cirugía , Pancreatectomía , Pancreatitis/patología , Factores de TiempoRESUMEN
Xenotransplantation of the pancreatic islet cells was performed in 8 patients with chronic pancreatitis and concomitant diabetes mellitus, operated on the pancreas. In 2 patients, the rejection of the cells transplanted occurred. The causes of failure and possibilities for improving the technique are analysed.
Asunto(s)
Trasplante de Islotes Pancreáticos , Pancreatitis/cirugía , Adulto , Animales , Animales Recién Nacidos , Células Cultivadas , Enfermedad Crónica , Complicaciones de la Diabetes , Femenino , Rechazo de Injerto , Humanos , Masculino , Pancreatitis/complicaciones , PorcinosRESUMEN
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.
Asunto(s)
Páncreas/cirugía , Pancreatectomía/métodos , Pancreatitis/cirugía , Enfermedad Crónica , Humanos , Páncreas/fisiopatología , Conductos Pancreáticos/cirugía , Pancreatitis/mortalidad , Pancreatitis/fisiopatologíaRESUMEN
In the experiment on 15 mongrel dogs, the pancreatoduodenal resection (PDR) with cholecystopancreatoanastomosis (CPA) formation was modelled. The advantages of CPA over pancreatojejunostomy were confirmed by morphological and histochemical investigations. In the institute of Clinical and Experimental Surgery, from 1983 to 1987, 73 PDRs were performed with CPA creation. Complications were noted in 34.2%, 9.6% of the patients died. The long-term results studied in 74.2% of the patients, in average, 26.6 mos after the intervention are good.