Comparative assessment of the short-term and long-term results of traditional and original ways of terminoterminal pancreatojejunostomy at a subtotal resection of a head of a pancreas

Abstract

Aim. Compare the short-term and long-term results of the traditional and original methods of terminoterminal pancreaticojejunostomy with subtotal resection of the pancreatic head.Materials and methods. The results of subtotal resection of the pancreatic head in 20 patients with chronic pancreatitis with pancreatic duct obstruction at the level of the head are analyzed. In 10 cases at the final stage of the operation, the traditional terminoterminal pancreaticojejunostomy was performed, in 10 – in the original way.Results. Biliary tract decompression was performed in 65% of patients. The average duration of operation from original terminoterminal pancreaticojejunostomy operation was 170 min. [165; 180], intraoperative blood loss – 210 ml [200; 240], the average duration of postoperative hospital stay – 16 days [14; 17]; there were no mortality. After 5 years, in all patients who underwent the original terminoterminal pancreaticojejunostomy, the expressiveness of pain according to the developed ten-point scale was <4 points. Frequency for the first time diagnosed diabetes was 50–60%. The need for enzyme drugs was noted in 37.5–40% of cases. The frequency of complications requiring repeated surgical interventions is 12%, persistent disability – 50%. The quality of life indicators for Medical Outcome Study Short Form-36 and European Organisation for Research and Treatment of Cancer quality of life questionnaire – C30 exceeded those of the traditional method of completing the surgery by 3.9–8.4% and 9.3–16.7%.Conclusion. The original way of a single-row terminoterminal pancreaticojejunostomy with subtotal resection of the pancreatic head allows to reduce averages operative time and postoperative hospital stay. The risk of hemorrhagic complications from the resected pancreatic head does not decrease (10%). After 5 years, an insignificant advantage of the original method of terminoterminal pancreaticojejunostomy compared with the traditional one was noted. The incidence of permanent disability was 15% less, the quality of life indicators for the Medical Outcome Study Short Form-36 and European Organisation for Research and Treatment of Cancer quality of life questionnaire – C30 were better.