CLINICAL AND MORPHOLOGICAL FEATURES AND LONG-TERM RESULTS OF SURGICAL TREATMENT OF CANCER OF THE PANCREAS HEAD
https://doi.org/10.51523/2708-6011.2016-13-4-10
Abstract
Objective : to carry out the comparative analysis of clinical and morphological pathologic factors and long-term results of surgical treatment of cancer of the pancreas head (CPH) depending on prior biliary drainage (PBD). Material and methods . 39 patients (group I) were performed single-step surgery, PBD was performed in 41 cases (group II) at a total bilirubin level of more than 200 umol/l. Results . The prevalence of cancer of the pancreas head in the surveyed groups did not differ, patients of groups I and II revealed low-grade ductal adenocarcinoma in 43 and 79 %, respectively (p = 0.003), the survival median was 14 and 13 months, 3-year survival rate was found in 28.9 ± 8.4 and 3.5 ± 3.4 %, 5-year - 19.3 ± 7.9 and 0 % (p = 0.04). Conclusion . It is advisable to expand the indications for single-step surgical treatment for CPH complicated by obstructive jaundice.
About the Authors
I. V. Mikhailov
Gomel State Medical University
Belarus
Belarus
T. N. Nesterovich
Gomel State Medical University
Belarus
Belarus
S. L. Achinovich
Gomel Regional Clinical Oncologic Dispensary
Belarus
Belarus
V. M. Bondarenko
Gomel State Medical University
Belarus
Belarus
V. A. Kudryashov
Gomel Regional Clinical Oncologic Dispensary
Belarus
Belarus
References
1. Сидоренко, А. М. Эпидемиология рака поджелудочной железы в XX и начале XXI века / А. М. Сидоренко, А. И. Шевченко, И. С. Кугаенко // Патология. - 2013. - № 1 (27). - С. 10-13.
2. Патютко, Ю. И. Современное хирургическое и комбинированное лечение больных экзокринным раком головки поджелудочной железы и органов периампулярной зоны / Ю. И. Патютко, А. Г. Котельников, М. Г. Абгарян // Практ. онкол. - 2004. - Т. 5, № 2. - С. 94-107.
3. A controlled randomized multicenter trial of pancreatogastrostomy or pancreatojejunostomy after pancreatoduodenectomy / J. P. Duffas [et al.] // Am. J. Surg. - 2005. - Vol. 189, № 6. - P. 720-729.
4. Shrikhande, S. V. Pancreatic fistula after pancreatico-duodenectomy: The impact of a standardized technique of pancreaticojejunostomy / S. V. Shrikhande, S. G. Barreto, P. J. Shukla // Langenbecks Arch. Surg. - 2008. - Vol. 393. - P. 87-91.
5. Adenocarcinoma of the Pancreas. Detection of occult metastases in regional lymph nodes by a polymerase chain reaction-based assay / M. J. Demeure [et al.] // Cancer. - 1998. - Vol. 83. - P. 1328-1334.
6. Results of Pancreaticoduodenectomy in Patients With Periampullary Adenocarcinoma Perineural Growth More Important Prognostic Factor Than Tumor Localization / M. H. van Roest [et al.] // Ann. Surg. - 2008. - Vol. 248, № 1. - P. 97-103.
7. Beger, H. G. Pancreatic cancer. The relative importance of neoadjuvant therapy / H. G. Beger [et al.] // Chirurg. (Germany). - 2003. - Vol. 74(3). - P. 202-227.
8. Meta-analysis of the efficacy of pancreatoduodenectomy with extended lymphadenectomy in the treatment of pancreatic cancer / X. Xu [et al.] // Worl. J. Surg. Onc. - 2013. - Vol. 311.
9. Лекарственная терапия в современном лечении рака поджелудочной железы / И. С. Базин [и др.] // Онкология, гематология и радиология. - 2011. - № 3. - С. 30-34.
10. Современные возможности комбинированного лечения рака поджелудочной железы / А. И. Шмак [и др.] // Медицинские новости. - 2010. - № 9. - С. 23-29.
11. Панкреатодуоденальная резекция в лечении хронического панкреатита и рака поджелудочной железы / Г. Д. Гунзынов [и др.] // Бюллетень ВСНЦ СО РАМН. - 2012. - № 4(86), Ч. 1. - С. 25-27.
12. Гастропанкреатодуоденальная резекция при злокачественных заболеваниях, осложненных механической желтухой / Ю. И. Патютко [и др.] // Хирургия. Журнал им. Н. И. Пирогова. - 2011. - № 2. - С. 25-32.
Review
For citations:
Mikhailov I.V., Nesterovich T.N., Achinovich S.L., Bondarenko V.M., Kudryashov V.A. CLINICAL AND MORPHOLOGICAL FEATURES AND LONG-TERM RESULTS OF SURGICAL TREATMENT OF CANCER OF THE PANCREAS HEAD. Health and Ecology Issues. 2016;(4):44-48. (In Russ.) https://doi.org/10.51523/2708-6011.2016-13-4-10
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