Abstract

The problem of choosing the method of surgical treatment of postnecrotic pancreatic cysts remains extremely urgent these days. With the development of technology, recently there has been a clear trend towards improving diagnostic capabilities and the emergence of an increasing number of minimally invasive methods of treatment, while traditional methods of surgical treatment do not lose their relevance, but recent studies optimize the indications for their implementation, which in turn reduces the frequency of the nearest and distant postoperative complications. In the article the questions concerning conservative therapy of postnecrotic cysts, indications and choice of a method of surgical treatment are considered. The methods of minimally invasive surgery are widely covered, the application of which allows achieving excellent clinical results of treatment. Particular attention is paid to the recent tendency of using several methods of minimally invasive treatment, the combination of minimally invasive internal and external drainage has shown its effectiveness, it should be noted that a good clinical result can be achieved by performing intervention data from the position of pathogenetic treatment. There are only a few data on the success of combined drainage of postnecrotic cysts, which requires confirmation by a large number of publications. Thus, the high incidence of acute pancreatitis, the lack of a diagnostic algorithm and clear indications for a wide range of existing methods of surgical treatment of postnecrotic pancreatic cysts leaves a field for subsequent studies and observations.

Highlights

  • There is a wide range of surgical interventions for pseudocyst, which can be divided into 2 groups – traditional surgical treatment and minimally invasive methods of surgical treatment

  • Most authors claim that when cysto-gastric anastomosis (CGA) and cystoduodenal anastomosis (CDA) are formed incidence of complications is higher, and mortality is up to 40 %, which is probably caused by gastric and duodenal contents reflux into the pseudocyst cavity [14, 21, 27, 29]

  • There have been limited indications for its implementation, this is associated with a high incidence of pseudocyst relapses, up to 40 % [34, 38]

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Summary

METHODS

OF TREATMENT OF POSTNECROCTIC PANCREATIC CYSTS: MODERN LOOKS OF THE PROBLEM (LITERATURE REVIEW). The article deals with the questions of conservative therapy of postnecrotic cysts, indications and choice of a method of surgical treatment. МЕТОДЫ ЛЕЧЕНИЯ ПОСТНЕКРОТИЧЕСКИХ КИСТ ПОДЖЕЛУДОЧНОЙ ЖЕЛЕЗЫ: СОВРЕМЕННЫЙ ВЗГЛЯД НА ПРОБЛЕМУ (ОБЗОР ЛИТЕРАТУРЫ). В настоящее время всё большую актуальность приобретают методы малоинвазивных вмешательств при постнекротических кистах поджелудочной железы: транскутанные пункционно-дренирующие вмешательства под ультразвуковым контролем, выполнение внутреннего эндоскопического транслюминального дренирования, стентирование вирсунгова протока, а также комбинации этих методов малоинвазивной хирургии. Pseudocyst formation is accompanied by complications, the frequency of which varies from 20 to 70 %, being the main cause of mortality in this pathology. The most formidable complication of pseudocyst, associated with a high risk of mortality to 60 %, is arrosive hemorrhage in the pseudocyst cavity, abdominal cavity and retroperitoneal tissue [1, 2, 3, 18, 26, 32, 33]

CONSERVATIVE TREATMENT OF PSEUDOCYST
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SURGICAL TREATMENT OF PSEUDOCYST
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