Subject(s)
Anastomosis, Surgical/methods , Cholelithiasis/surgery , Hemobilia/surgery , Hepatic Artery/surgery , Hepatic Duct, Common/surgery , Adult , Cholecystectomy, Laparoscopic , Cholelithiasis/pathology , Female , Hemobilia/pathology , Hepatic Artery/pathology , Hepatic Duct, Common/pathology , Humans , ReoperationABSTRACT
The results of laparoscopic treatment were analyzed in 9 patients, suffering pancreatic insulinoma, in the clinic in 2008-2012 yrs. Tumoral enucleation was performed in 6 patients, distal pancreatic resection--in 3. In 1 (11.1%) patient postoperative external pancreatic fistula have developed. All the patients are alive. Laparoscopic treatment of the patients, suffering insulinoma is effective and secure.
Subject(s)
Hyperinsulinism/etiology , Insulin/metabolism , Insulinoma/surgery , Laparoscopy/methods , Pancreatic Neoplasms/surgery , Adult , Endosonography , Female , Humans , Hyperinsulinism/metabolism , Hyperinsulinism/surgery , Insulin Secretion , Insulinoma/complications , Insulinoma/diagnosis , Insulinoma/metabolism , Magnetic Resonance Imaging , Male , Pancreatic Neoplasms/complications , Pancreatic Neoplasms/diagnosis , Pancreatic Neoplasms/metabolism , Tomography, Spiral Computed , Treatment OutcomeABSTRACT
The results of diagnosis and treatment in 2004-2012 yrs period of 79 patients, suffering nonfunctioning neuroendocrine pancreatic tumors (NNPT), were analyzed. Effective diagnostic tactic while preoperative predilection on the NNPT presence for the diagnosis verification was proposed, permitting to determine the optimal method of surgical treatment, to introduce organpreserving and laparoscopic interventions, to widen indications for surgery for the NNPT extended forms.
Subject(s)
Biomarkers, Tumor/genetics , Ki-67 Antigen/genetics , Pancreatic Neoplasms/diagnosis , Pancreatic Neoplasms/surgery , Chromogranin A/genetics , Female , Humans , Male , Mitosis , Neoplasm Grading , Pancreatectomy , Pancreatic Neoplasms/classification , Pancreatic Neoplasms/diagnostic imaging , Radiography , Retrospective StudiesABSTRACT
The results of treatment of 56 patients, in whom in 1984-2010 yrs, while performing cholecystectomy, a biliary duct injury have occurred, were analyzed, including 26 (main group)--with combined injury of biliary ducts and brunches of common hepatic artery, 30 (control group)--with isolated complete biliary ducts. High hepaticojejunostomy have constituted the main method of operation in a control group. In the main group in 2 patients there were attempts made to restore the arterial blood flow with subsequent performance of reconstructive intervention on biliary ducts. In 16 (61.5%) patients, due to adequate collateral blood supply presence, the bile outflow was restored using hepaticojejunostomy formation, and in 8 (30.8%)--hepatic resection of various volume was needed, because of hepatic abscesses formation. The results of treatment of patients in these groups have differed not essentially, while applying differentiated approach (positive results were achieved in 93.3 and 84.6% of patients, accordingly). So, in patients with combined injury of biliary ducts and branches of hepatic artery, while performance of cholecystectomy, it is necessary to apply multimodal tactics of treatment, taking into account the peculiarities of clinical course.
