eISSN: 1897-4317
ISSN: 1895-5770
Gastroenterology Review/Przegląd Gastroenterologiczny
Bieżący numer Archiwum Artykuły zaakceptowane O czasopiśmie Bazy indeksacyjne Prenumerata Kontakt Zasady publikacji prac
Portal dla gastroenterologów!
SCImago Journal & Country Rank
vol. 13
Poleć ten artykuł:
streszczenie artykułu:
Artykuł oryginalny

Peculiarities of diagnostics of billiary hypertension in patients with complicated forms of chronic pancreatitis

Volodymyr Pylypchuk

Data publikacji online: 2018/05/16
Pełna treść artykułu
Pobierz cytowanie
JabRef, Mendeley
Papers, Reference Manager, RefWorks, Zotero

The morbidity of chronic pancreatitis (CP) remains at a high level. In cases of CP, prepapillary stenosis of the common bile duct (CBD) complicates the course of disease in 30–60% of patients.

To improve the detection of biliary hypertension (BH) in patients with complicated forms of CP by increasing the accuracy of preoperative and intraoperative diagnostics using modern diagnostic methods.

Material and methods
We analysed the results of surgical treatment of 573 patients with complicated forms of CP. In 163 (28.5%) patients, CP was complicated by BH. The method of intraoperative monitoring of biliary pressure (IOM BP) was developed and introduced for intraoperative control and determination of the adequacy of intervention regarding biliary decompression.

Mechanical jaundice was diagnosed by clinical methods in 101 (61.9%) CP patients with BH, and by laboratory methods in 108 (66.2%) patients. Such methods as magnetic resonance cholangiopancreatography (95.6%), endoscopic retrograde cholangiopancreatography (93.7%), and computed tomography (93.8%) proved to have the highest sensitivity for the diagnostics of BH in cases of CP.

The application of an integrated approach with extensive use of modern non-invasive preoperative methods of assessment allowed an approximation of the reliability of preoperative diagnostics of BH in CP patients to 95.6%. The use of the IOM BP method enables us to increase the sensitivity of intraoperative diagnostics of BH to 97.3% and choose the method of surgical intervention, which significantly reduces the risk of BH recurrence in the distant postoperative period by 15.1% (χ2 = 4.22, p = 0.04).

Prosolenko KA. Cure of patients with chronic pancreatitis according to the latest Ukrainian standards. Vestnik klub apankreatologov 2016; 2: 5-11.
Rusyn VI, Filip SS, Boldizhar OO, et al. Surgical treatment of chronic pancreatitis. Kharkiv Surgical School 2014; 2: 29-34.
Kryvoruchko IA, Boyko VV, Goncharova NN. Surgical treatment of chronic pancreatitis with regard to the classification of M. Buchler et al. (2009). Suchasni medychni tekhnolohiyi 2011; 3-4: 195-8.
Kovalska I, Dronov O, Beregova T, et al. Changes of bile composition in patients with chronic pancreatitis. Pancreatology 2014; 14 (3 Suppl): S102.
Dobrov SD, Polyakevich AS, Blagitko EM, et al. Bile hypertension in patients with chronic pancreatitis. Annaly khirurgicheskoy gepatologii 2012; 4: 35.
Gagua AK, Vorobyov PY, Valkov KC, et al. Choose of the optimal volume of surgery in patients with chronic pancreatitis complicated by biliary hypertension. Materials of the XXIII International Congress on the Association of Hepatopancreatobiliary Surgeries of the CIS “Actual problems of hepatopancreatobiliary surgery”. Minsk 2016; 230-1.
Sebastiano P, Molla FF. Pathophysiology of chronic damage. In: Acute and Chronic Pancreatitis: New concepts and evidence-based approaches. Testoni PA, Mariani A, Arcidiacono PG (eds). Edizioni Minerva Medica, Turin 2013; 63-9.
Kleeff J, Stöß C, Mayerleetal J. Evidence-based surgical treatments for chronic pancreatitis. Dtsch Arztebl Int 2016; 113: 489-96.
Grinevich VB, Maistrenko NA, Pryadko AS, et al. The problem of chronic pancreatitis from the position of a therapist and a surgeon. Meditsinskiy Akademicheskiy Zhurnal 2012; 12: 35-55.
Shuleyko AC, Vorobey AV, Grishin IN, et al. Biliary hypertension in patients with chronic pancreatitis. Materials of the Jubilee International Congress of Association of Surgeons-Hepatologists of CIS “Actual Problems of Surgical Hepatology”. Donetsk 2013; 301.
Drewes AM. Endoscopic management of complications of chronic pancreatitis. World J Gastroenterol 2013; 19: 7308-15.
Strate T, Taherpour Z, Bloechle C. Long-term follow-up of a randomized trial comparing the beger and frey procedures for patients suffering from chronic pancreatitis. Ann Surg 2005; 241: 591-8.
Maev IV, Ivashkin VT, Kaziulin AN, et al. Clinical recommendations for diagnosis and treatment of chronic pancreatitis. Moscow 2013; 42.
Johnstone M, Jackson R, Hannaetal T. The diagnosis of chronic pancreatitis: a systematic review. Pancreatology 2014; 14: 41.
Pat. 101713 Ukraine, IPC A 61B 17/00. Method of surgical treatment of chronic pancreatitis complicated with cholelithiasis. Pylypchuk VI, Kopchak VM, Shevchuk IM (Ukraine). No 2015 03315; stated 04/09/2015; published September 25, 2015 Bull No 18.
Pat. 109547 Ukraine, IPC A 61B 17/00. Method of measuring the pressure in the common bile duct. Pylypchuk VI, Kopchak VM, Shevchuk IM (Ukraine). No 2016 02279; stated March 10, 2016; published 08/25/2016 Bull No 16.
© 2019 Termedia Sp. z o.o. All rights reserved.
Developed by Bentus.
PayU - płatności internetowe