ABSTRACT
AIM: To present 18-year experience of endoscopic transpapillary stenting in patients with pancreatic fistula. MATERIAL AND METHODS: The study included 48 patients with pancreatic fistula resistant to conservative management. Pancreatic stenting was successful in 32 (66.7%) patients. In 30 (93.8%) of them stenting appeared as the final stage of pancreatic fistula treatment. RESULTS: Inclidence of complications after endoscopic treatment was 4.2%. We evaluated long-term results in 23 cases within 8-184 months. There were good results in 21 (91.3%) cases and satisfactory - in 2 (8.7%) cases. We had not unsatisfactory results in our experience.
Subject(s)
Endoscopy, Digestive System , Pancreas , Pancreatic Fistula , Postoperative Complications , Stents , Adult , Cholangiopancreatography, Endoscopic Retrograde/methods , Conservative Treatment/adverse effects , Endoscopy, Digestive System/adverse effects , Endoscopy, Digestive System/instrumentation , Female , Humans , Male , Middle Aged , Outcome and Process Assessment, Health Care , Pancreas/diagnostic imaging , Pancreas/surgery , Pancreatic Fistula/diagnosis , Pancreatic Fistula/physiopathology , Pancreatic Fistula/surgery , Patient Selection , Postoperative Complications/diagnosis , Postoperative Complications/etiology , RussiaABSTRACT
AIM: to evaluate objectively the effectiveness of currently used diagnostic and curative approaches to gastrointestinal stromal tumors (GIST). MATERIAL AND METHODS: Early and remote results of treatment of 49 patients with gastric GISTs were presented. Herewith in 20 (40.8%) patients the disease was complicated by gastrointestinal bleeding. 43 (87.7%) of 49 patients with gastric GIST were operated. Conventional surgery was performed in 24 (55.8%) cases, laparoscopic interventions - in 12 (28%) cases, endoscopic endoluminal - in 7 (16.2%). 6 (14.2%) patients were not operated. RESULTS: Intraoperative complications were observed in 2 (4.65%) patients. In postoperative period complications occurred also in 2 (4.65%) patients. In long-term postoperative period tumoral process progression was observed in 3 (8.3%) patients. Recurrence was diagnosed in 2 (5.6%) patients.
Subject(s)
Gastrectomy , Gastrointestinal Hemorrhage , Gastrointestinal Stromal Tumors , Neoplasm Recurrence, Local/diagnosis , Postoperative Complications/diagnosis , Stomach Neoplasms , Aged , Female , Gastrectomy/adverse effects , Gastrectomy/methods , Gastrointestinal Hemorrhage/etiology , Gastrointestinal Hemorrhage/surgery , Gastrointestinal Stromal Tumors/complications , Gastrointestinal Stromal Tumors/pathology , Gastrointestinal Stromal Tumors/surgery , Gastroscopy/adverse effects , Gastroscopy/methods , Humans , Laparotomy/adverse effects , Laparotomy/methods , Long Term Adverse Effects/diagnosis , Male , Middle Aged , Outcome and Process Assessment, Health Care , Stomach Neoplasms/complications , Stomach Neoplasms/pathology , Stomach Neoplasms/surgeryABSTRACT
AIM: To present the results of perforative duodenal ulcer surgical management using combination of endoscopic methods. MATERIAL AND METHODS: The study included 279 patients with perforative duodenal ulcer who were operated for the period from 1996 to 2012. Diagnostics and medical tactics were based on developed in our clinic algorithm that includes use of both esophagogastroduodenoscopy and laparoscopy. CONCLUSION: Presented technique confirmed correct diagnosis, defined medical tactics and choice of surgery in 100% of cases. 67 patients had contraindications for laparoscopic suturing and underwent conventional operations. Herewith postoperative complications and death were observed in 25 (37.3%) and 9 (13.4%) patients respectively. Laparoscopic suturing was performed in 212 patients. Complications were diagnosed in 19 (8.9%) cases including 8 (3.7%) intraoperative and 11 (5.2%) postoperative. Deaths were absent.
Subject(s)
Duodenal Ulcer , Endoscopy, Digestive System , Laparoscopy , Peptic Ulcer Perforation , Postoperative Complications/epidemiology , Duodenal Ulcer/diagnosis , Duodenal Ulcer/mortality , Duodenal Ulcer/surgery , Endoscopy, Digestive System/adverse effects , Endoscopy, Digestive System/methods , Female , Humans , Laparoscopy/adverse effects , Laparoscopy/methods , Male , Middle Aged , Peptic Ulcer Perforation/diagnosis , Peptic Ulcer Perforation/mortality , Peptic Ulcer Perforation/surgery , Survival Analysis , Treatment OutcomeABSTRACT
It is presented the results of diagnostic and curative laparoscopic interventions in 33 patients with acute early adhesive small bowel obstruction. Ileus developed after surgical treatment (laparotomy) of different gynecological diseases. Laparoscopy appeared as the most informative diagnostic method to confirm diagnosis in all patients, to estimate state of abdominal cavity and small pelvis organs what can help to determine method of surgical treatment. Contraindications for laparoscopic surgery were identified in 12 (36.4%) patients and conversion to laparotomy was applied in this group. Postoperative complications were diagnosed in 1 (8.3%) patient. 2 (16.6%) patients died. Early adhesive ileus was resolved laparoscopically in 21 (63.6%) of 33 patients. Recurrent acute early adhesive ileus was detected in 1 (4.7%) patient.
