ABSTRACT
The paper considers the problems of enhancing the efficiency of diagnosis and treatment of Vater's papilla cancer complicated by jaundice, by maximally realizing the capacities of instrumental studies and by improving the procedures of combination treatment and radiotherapy for this disease. The achieved treatment results show it expedient to use combination treatment and, if radical surgery is contraindicated, radiotherapy for Vater's papilla cancer.
Subject(s)
Ampulla of Vater , Common Bile Duct Neoplasms/diagnosis , Common Bile Duct Neoplasms/therapy , Combined Modality Therapy , Common Bile Duct Neoplasms/complications , Common Bile Duct Neoplasms/radiotherapy , Female , Humans , Jaundice/etiology , Male , Middle Aged , Treatment OutcomeABSTRACT
The study was undertaken to enhance the efficiency of diagnosis of pancreatobiliary cancer complicated by jaundice by using the potentialities of currently available instrumental studies at most. The data of examination of 256 patients with this disease are presented. Based on diagnostic findings, the authors have constructed a diagnostic model of precision recognition of cancer of the extrahepatic bile ducts, pancreatic head, Vater's papilla.
Subject(s)
Ampulla of Vater , Bile Duct Neoplasms/diagnosis , Bile Ducts, Extrahepatic , Common Bile Duct Neoplasms/diagnosis , Jaundice/etiology , Pancreatic Neoplasms/diagnosis , Ampulla of Vater/diagnostic imaging , Bile Duct Neoplasms/diagnostic imaging , Bile Ducts, Extrahepatic/diagnostic imaging , Cholangiography , Cholangiopancreatography, Endoscopic Retrograde , Common Bile Duct Neoplasms/diagnostic imaging , Endoscopy, Digestive System , Humans , Models, Theoretical , Pancreatic Neoplasms/diagnostic imaging , Syndrome , UltrasonographyABSTRACT
The effectiveness of therapy of pancreato-biliary cancer in jaundice patients has been raised due to introduction of sparing slightly-invasive (percutaneous, transhepatic) procedures for suppression of choleostasis and restoring biliary return to intestine. Also, such measures as pancreato-digestive anastomosis, radical surgery to compensate jaundice-related functional and morphological disorders and changes in the liver as well as perfection of procedures of combined and radiation therapy were used.
Subject(s)
Biliary Tract Neoplasms/diagnosis , Biliary Tract Neoplasms/therapy , Biliary Tract Surgical Procedures/methods , Jaundice/etiology , Pancreatic Neoplasms/diagnosis , Pancreatic Neoplasms/therapy , Adult , Aged , Anastomosis, Surgical/methods , Biliary Tract Neoplasms/complications , Biliary Tract Neoplasms/radiotherapy , Biliary Tract Neoplasms/surgery , Diagnosis, Differential , Female , Humans , Male , Middle Aged , Palliative Care , Pancreatic Neoplasms/complications , Pancreatic Neoplasms/radiotherapy , Pancreatic Neoplasms/surgery , Radiotherapy, Adjuvant , Survival Analysis , Treatment OutcomeSubject(s)
Angiography , Thoracic Diseases/diagnostic imaging , Adult , Diagnosis, Differential , Female , Humans , Male , Middle Aged , Radiology, InterventionalABSTRACT
Morphological investigations at the preoperative stage were performed in 94 patients. The morphological diagnosis was made on the basis of findings of duodenal biopsies, cytological investigations of the bile and aspirate from the Vater's papilla ampulla, endocholedochal and percutaneous biopsies with the express cytological monitoring. Recommendations are given on the programs of preoperative morphological diagnosis of carcinoma of Vater's papilla.
Subject(s)
Biliary Tract Neoplasms/pathology , Duodenal Neoplasms/pathology , Liver Neoplasms/pathology , Pancreatic Neoplasms/pathology , Adult , Aged , Aged, 80 and over , Ampulla of Vater/pathology , Bile/cytology , Biliary Tract Neoplasms/surgery , Biopsy, Needle , Common Bile Duct/pathology , Common Bile Duct Neoplasms/pathology , Common Bile Duct Neoplasms/surgery , Cytodiagnosis , Duodenal Neoplasms/surgery , Duodenum/pathology , Female , Humans , Liver Neoplasms/surgery , Male , Middle Aged , Pancreatic Neoplasms/surgerySubject(s)
Ampulla of Vater/surgery , Carcinoid Tumor/surgery , Cholestasis/surgery , Common Bile Duct Neoplasms/surgery , Carcinoid Tumor/complications , Carcinoid Tumor/diagnosis , Cholestasis/diagnosis , Cholestasis/etiology , Common Bile Duct Neoplasms/complications , Common Bile Duct Neoplasms/diagnosis , Humans , Male , Middle AgedSubject(s)
Cholestasis/diagnosis , Hodgkin Disease/diagnosis , Liver Neoplasms/secondary , Pancreatic Neoplasms/secondary , Adult , Cholestasis/etiology , Cholestasis/therapy , Combined Modality Therapy , Female , Hodgkin Disease/complications , Hodgkin Disease/therapy , Humans , Liver Neoplasms/complications , Liver Neoplasms/diagnosis , Liver Neoplasms/therapy , Lymphatic Metastasis , Pancreatic Neoplasms/complications , Pancreatic Neoplasms/diagnosis , Pancreatic Neoplasms/therapyABSTRACT
The paper is concerned with comparative assessment of the efficacy of digital subtraction angiography and routine angiography in assessing tumor spreading in pancreatobiliary cancer. A combined method of digital subtraction angiography and cholangiography was developed and performed in 41 patients with pancreatobiliary cancer permitting maximum information on the topical location and spreading of a tumor process. The clinical importance of the obtained results permitted recommending simultaneous digital subtraction angiography and cholangiography in patients with hepatobiliary cancer.
Subject(s)
Angiography, Digital Subtraction , Biliary Tract Neoplasms/diagnostic imaging , Cholangiography , Pancreatic Neoplasms/diagnostic imaging , Ampulla of Vater/blood supply , Ampulla of Vater/diagnostic imaging , Biliary Tract Neoplasms/blood supply , Common Bile Duct/blood supply , Common Bile Duct/diagnostic imaging , Common Bile Duct Neoplasms/blood supply , Common Bile Duct Neoplasms/diagnostic imaging , Hepatic Artery/diagnostic imaging , Humans , Pancreas/blood supply , Pancreas/diagnostic imaging , Pancreatic Neoplasms/blood supplyABSTRACT
Treatment of 46 patients with mechanical jaundice of the inflammatory-calculous and tumorous nature is described. In 26 patients with external drainage of the bile ducts the cytological investigation of 3-5 morning portions of bile was performed. The lavage fluid was studied in 4 cases. On the basis of the findings of these cytological investigations carcinoma was diagnosed in 20 of 24 patients with tumorous processes (83.3%). A comparison of data obtained by histological and cytological investigations in 19 patients operated upon was made.
Subject(s)
Bile/cytology , Biliary Tract Neoplasms/diagnosis , Pancreatic Neoplasms/diagnosis , Biliary Tract/pathology , Biliary Tract Neoplasms/complications , Biliary Tract Neoplasms/pathology , Biliary Tract Neoplasms/surgery , Cholestasis/diagnosis , Cholestasis/etiology , Cytodiagnosis/methods , Humans , Pancreas/pathology , Pancreatic Neoplasms/complications , Pancreatic Neoplasms/pathology , Pancreatic Neoplasms/surgery , Therapeutic IrrigationSubject(s)
Bile Duct Diseases/diagnostic imaging , Cholestasis/diagnostic imaging , Jaundice/diagnostic imaging , Liver Diseases/diagnostic imaging , Pancreatic Diseases/diagnostic imaging , Adolescent , Adult , Aged , Bile Duct Diseases/complications , Child , Cholestasis/etiology , Diagnosis, Differential , Female , Humans , Jaundice/etiology , Liver Diseases/complications , Male , Middle Aged , Pancreatic Diseases/complications , UltrasonographyABSTRACT
The authors make an analysis of the operative treatment of 525 patients with cancer of the hepato-biliary and pancreatoduodenal zones. The distal, central and proximal obturations of bile ducts were found which determined the indications to formation of various bilio-digestive anastomoses. The operation of choice for distal obturation is a wide areflux cholecystogastrostomy with the use of blanket suture with the chromium-coated catgut. In the central and proximal obturation the precision suture with an atraumatic suture material and magnifying optics are recommended.
