Медицинская литература. Новинки

 

 

 

 

 

 

Функциональные результаты панкреатодуоденальной резекции

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В настоящее время панкреатодуоденальная резекция, несмотря на большую частоту осложнений, сопровождается приемлемым уровнем послеоперационной летальности. Это, наряду с существенным увеличением выживаемости при раке поджелудочной железы, делает необходимым изучение негативных функциональных последствий операции и методов их хирургической профилактики. В обзоре литературы представлена характеристика трех основных послеоперационных синдромов: гастростаза, панкреатической экзокринной и эндокринной недостаточности. Показана зависимость проявлений указанных синдромов от патоморфологических характеристик культи поджелудочной железы, сохранения привратника, варианта панкреатодигестивного анастомоза и других особенностей реконструктивного этапа операции.

Ключевые слова:
поджелудочная железа, панкреатодуоденальная резекция, панкреатогастроанастомоз, панкреатоеюноанастомоз, гастростаз, экзокринная недостаточность, эндокринная недостаточность

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Functional outcomes of pancreaticoduodenoctomy

At present, pancreaticoduodenoctomy causes the high incidence of complications. However, it is associated with an acceptable level of postoperative mortality. With this regard and taking into consideration a significant increase in survival in pancreatic cancer, it is highly relevant to study the negative functional outcomes of surgery and develop methods for their surgical prevention. The bibliographic review focuses on the features of three main postsurgical syndromes: gastric stasis, pancreatic exocrine and endocrine insufficiency. The study shows the dependence of these syndromes on pathomorphological characteristics of pancreatic stump, preservation of the pyloric, the variant of pancreatodigestive anastomosis and other features of reconstructive stage of the surgery.

Keywords:
pancreas, pancreaticoduodenoctomy, pancreaticogastrostomy, pancreaticojejunostomy, gastric stasis, exocrine insufficiency, endocrine insufficiency