RESUMO
In 38 elderly and senile patients, in whom an acute necrotic pancreatitis (ANP) was diagnosed, morphological changes in the walls of intra- and extrapancreatic arteries were studied, including dorsal pancreatic artery, big pancreatic artery (Heller) and their branches. The patients were operated, using open surgical access, on the 10 - 26-th day after admittance to hospital for purulent-septic complications of pancreonecrosis. In total 9 (24%) patients died. Changes of intra- and extrapancreatic arteries causes the essential reduction of the splanchnic blood flow intensity and necrotic changes in pancreatic parenchyma and parapancreatic cellular space.
Assuntos
Artéria Mesentérica Superior/patologia , Pâncreas/patologia , Pancreatite Necrosante Aguda/patologia , Artéria Esplênica/patologia , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Microscopia , Pâncreas/irrigação sanguínea , Pâncreas/cirurgia , Pancreatite Necrosante Aguda/mortalidade , Pancreatite Necrosante Aguda/cirurgia , Circulação Esplâncnica , Análise de SobrevidaRESUMO
Results of surgical treatment of 120 patients, suffering complicated forms of chronic pancreatitis, were analyzed. In 5 patients pancreaticoduodenal resection in accordance to Whipple method have constituted the operation of choice. The indications for operation were: impossibility to exclude completely the malignant process inside pancreatic head; enhancement of the pancreatic head, causing duodenal, common biliary duct and the pancreatoduodenal zone vessels compression; cystic changes of pancreatic head with several episodes of hemorrhage inside the cyst and duodenum. The immediate, short-term and intermediate results of the operation were estimated as good and satisfactory.
