Saratov JOURNAL of Medical and Scientific Research

pancreas

Effect of different pancreatic stump closure techniques during distal pancreatectomy to the frequency and severity of acute postoperative pancreatitis

Year: 2018, volume 14 Issue: №2 Pages: 260-265
Heading: Surgery Article type: Original article
Authors: Voskanyan S.E., Naydenov E.V., Uteshev l.Yu., Artemiev A.l.
Organization: State Scientific Research Center n.a. A.I. Burnasyan — Federal Medical Biophysical Center of Federal Medical Biological Agency
Summary:

The Aim: to study the effect of different pancreatic stump closure techniques, including depending on the diameter of the main pancreatic duct to frequency and severity of acute postoperative pancreatitis after distal pancreatectomy. Material and Methods. Distal pancreatectomies were performed in 126 patients with neoplasms of the body and/or tail of the pancreas. Patients were divided into 4 groups depending on the pancreatic stump closure techniques. Group 1 (control): isolated suturing of the main pancreatic duct of the pancreatic stump with its sealing by gastrocolic omentum or hemostatic sponge; group 2: isolated suturing of the main pancreatic duct of the pancreatic stump with its sealing by biological glue 2-octylcyanoacrylate; group 3: pancreatic stump closure were performed by Endoscopic Linear Cutter; group 4: after distal pancreatectomy were performed external transduodenal transnasal drainage of the enlarged main pancreatic duct of pancreatic stump. Results. The frequency of acute postoperative pancreatitis in the control group of patients was 45.8%, in the group 2 of patients — 44.4%, in the group 3 of patients — 9.7%, in the group 4 of patients — 15.0%. The use of the proposed pancreatic stump closure techniques after distal pancreatectomy resulted in a decrease of the frequency of moderate form of acute postoperative pancreatitis. The use of Endoscopic Linear Cutter and external transduodenal transnasal drainage of the enlarged main pancreatic duct resulted in decrease of frequency of acute postoperative pancreatitis in patients with a diameter of the main pancreatic duct of the pancreatic stump up to 5 mm. Conclusion. The use of the proposed pancreatic stump closure techniques after distal pancreatectomy resulted in the decrease of frequency and severity of acute postoperative pancreatitis.

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Dynamics of laser speckle imaging of blood flow in the tissues at partial temporary pancreatic ischemia of hungry, fed and alcoholized rats

Year: 2016, volume 12 Issue: №2 Pages: 106-109
Heading: Macro- and Micromorphology Article type: Original article
Authors: Alexandrov D.A., Timoshina P.A., Tuchin V.V., Maslyakova G.N., Palatova T.V., Sedov D.S., Izmailov R.R.
Organization: Saratov State Medical University
Summary:

The aim of the study is to determine the influence of a partial temporary ischemia and reperfusion on the development of pancreatitis in laboratory rats. Material and Methods. The experiments were performed on 73 white rats. Occluded blood vessels and blood flow were recorded by digital biomicroscopy and laser speckle contrast imaging. Statistical data processing was carried out the program Statistica for Windows 6.0 using the Student's criterion. Results. Laser speckle imaging and digital microscopes provide the monitoring of blood flow in the vessels of the pancreas. After a five-minute partial ischemia reactive hyperemia occurs, changes are invertible. After a twenty-minute partial ischemic reactive hyperemia does not occur, without developing pancreatitis necrosis. Pancreas of alcoholized rats has been found out to be more sensitive to ischemia. Conclusion. The method of laser speckle imaging and intravital microscopy after digital five- and twenty-minute partial ischemia of the pancreas revealed phase opposite directed changes in its tissue perfusion and varying severity of postischemic pancreatitis.

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The clinical significance of the prevalence of parapancreatitis in pan-creonecrosis

Year: 2016, volume 12 Issue: №1 Pages: 57-60
Heading: Surgery Article type: Original article
Authors: Alexandrov D.A., Tolstokorov A.S., Sedov D.S.
Organization: Saratov State Medical University
Summary:

Tftea/m of the study is to determine the relationship of clinical surgical treatment options of degradation of retroperi-tonealfat. Material and Methods. We have analyzed the results of treatment of 1177 patients with necrotizing pancreatitis, taking into account the severity and characteristics of parapancreatitis. Statistical data processing was carried out by the program Statistica for Windows 6.0. using the Student's criterion. Results. The variety of clinical forms of pancreatic necrosis due to a combination of options lesions of the pancreas and retroperitoneal fat. The outcome of pancreatic necrosis is determined not only by the degree of destruction of the pancreas, but also features parapancreatitis. The allocation of limited and common prevalence of parapancreatitis was substantiated and specified. Conclusion. The effectiveness of the treatment of pancreatic necrosis is dependent on the development options of parapancreatitis which present the predictive and tactical value.

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Dynamics of laser speckle imaging of blood flow and morphological changes in tissues with a full time local ischemia of pancreas

Year: 2014, volume 10 Issue: №4 Pages: 596-600
Heading: Macro- and Micromorphology Article type: Original article
Authors: Alexandrov D.A., Timoshina P.A., Tuchin V.V., Maslyakova G.N., Palatova T.V., Skorokhod A.A., Lukashevich K.A., Yarovoy A.S..
Organization: Saratov State Medical University, Saratov state university
Summary:

The purpose: to establish influence of a full ischemia of different duration and the subsequent reperfusionon pathology development in pancreas of rats by means of laser speckle-visualization and lifetime digital microscopy. Materials and Methods. The work has been performed on 42 white rats of line Wistar in weight of 200-250 Research of properties of a blood-groove was made by means of methods laser Doppler flowmetry, digital biomicroscopy and a method of laser speckle-contrast visualization. Results. After the termination of a 5-minute full ischemia the speed of bloodflow has been increased in 2-3 times, clinic pancreatic necrosis is marked does not develop. After the termination of 20-minute full ischemia the increase in speed of a bloodflow did not occur, there were morphological and clinical signs of pancreatic necrosis. Conclusion, the efficiency of monitoring of microhemodynamics of pancreas in rats by the method of speckle-capillary of full field has been shown. Multidirectional phase of perfusion changes in pancreas have been revealed after reversible infringement of blood supply of different duration.

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Population aspects of formation of gastroenterological pathology in patients of different age groups

Year: 2011, volume 7 Issue: №4 Pages: 783-786
Heading: Health Service Organization Article type: Short message
Authors: Shuldyakov V.A., Tyultyaeva L.A, Denisova T.P., Chernenkov Yu.V., Alipova L.N.
Organization: Saratov State Medical University, Saratov Regional Hospital for Veterans of Wars
Summary:

Process of development of the most important forms of pathology of the digestive organs among people of different ages has been analyzed in a large industrial center for sixteen years. The age groups liable to gastroenterological pathology have been identified under conditions of social stress

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