I.A. KOZLOV, V.A. VISHNEVSKY, A.V. CHZHAO, M.D. BAYDAROVA

A.V. Vishnevsky Institute of Surgery of the Ministry of Health of the Russian Federation, 27 Bolshaya Serpukhovskaya Str., Moscow, Russian Federation, 117997

Kozlov I.A. — D. Med. Sc., Senior Research Scientist of the Department of abdominal surgery No. 2, tel. +7-916-390-93-64, e-mail: kozlov@ixv.ru

Vishnevsky V.A. — D. Med. Sc., Professor, Head of the Department of abdominal surgery No. 2, tel. (499) 237-80-54, e-mail: vishnevskyVA@ixv.ru

Chzhao A.V. — D. Med. Sc., Professor, Deputy Director for Science, tel. (499) 237-13-57, e-mail: chzhao@ixv.ru

Baydarova M.D. — resident physician of the Department of abdominal surgery No. 2

The article describes the experience of surgical treatment of 646 patients with chronic pancreatitis for the period of years 2005-2014. Drainage of the ductal pancreatic gland (PG) system was performed in 260 (40%) patients (pancreatitis cystoanastomosis in the P-loop of the small intestine — 101, longitudinal pancreatojunoanastomosis — 89, external drainage of postnecrotic cysts — 54, endoscopic internal drainage — 16 patients). Pancreatic resections were performed in 344 (53.3 %) patients (Frey procedure — 90, the Bernese method of pancreatic head resection — 65, Beger procedure — 53, and total pancreatic head resection with circular duodenal resection — 13). Pancreaticoduodenectomy was performed in 69 patients. Distal resection of the PG was performed in 48 patients, medial pancreatectomy — 6 patients. With false aneurysms, combined treatment (endovascular and surgical) was performed in 23 patients, endovascular — 13 patients. Complications occured in 179 (27.7 %) patients after the operation, 10 (1.5 %) patients died. A survey in the long term (from 1 year to 12 years) after various types of surgical interventions was conducted in 197 patients. The presented analysis indicates that proximal resection of the pancreas can reliably eliminate the focus of pathological changes and suppress pain symptoms in chronic pancreatitis. Pancreatic head resection with preservation of the duodenum at the absolute radical intervention in most cases is characterized by more favorable functional results long after the operation than the operation of PDR and pancreaticojejunoanastomosis.

Key words: chronic pancreatitis, pancreas resection, pancreaticojejunoanastomosis, pancreaticoduodenal resection.

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