Detailed Abstract
[E-poster - Biliary & Pancreas (Pancreas Disease/Surgery)]
[EP 170] Comparative indicators of minimally invasive and traditional interventions in patients with postoperative pancreonecrosis
Farukh Mahmadzoda1, Akbar Murodov2, Davlatmurod Sadulloev3, Abdurahmon Ashurov 1, Kamol Barotov1, Farukh Mahmadzoda1
Department of Surgical Diseases №1, Avicenna Tajik State Medical University, Dushanbe, Tajikistan1, Department of Surgical Diseases №1, Scientific Center of Oncology of the Republic of Tajikistan, Dushanbe, Tajikistan2, Department of Surgical Diseases №1, Institute of Gastroenterology of the Republic of Tajikistan, Dushanbe, Tajikistan3
Background : To study the comparative indicators of minimally invasive and traditional interventions in patients with postoperative pancreatic necrosis.
Methods : 34 patients with postoperative pancreatic necrosis were analyzed. Of these, 70.6% were operated on using minimally invasive technologies, 29.4% using the open method. Focal pancreatic necrosis occurred in 41.2% patients, massive - in 35.3%, total-subtotal - in 23.5%. Including in 35.3% of cases, percutaneous drainage interventions were performed in patients of the main group, with pancreatic puncture taken (table 1).
Results : When performing puncture-drainage interventions, importance was attached to the distance from the puncture site on the body surface to the border of the fluid accumulation. Moreover, it ranged from 15 to 130 mm. In 83.3% of cases, puncture-drainage interventions were performed through the anterior abdominal wall; while draining the omental bursa, in 20% of cases a translube paravertebral approach was performed. Histological examination of pancreatic biopsies showed that areas of pancreatic tissue necrosis occupy from 20 to 90% of the specimen area. When examining punctures of liquid formations, it was found that in 9 out of 24 cases, the growth of bacteria from destructive areas of the pancreas was observed. In the remaining 15 cases, there was no growth of bacterial flora. Monoculture was found in 4 out of 9 cases, and in the remaining 55.6% cases an association of bacteria was detected. Relaparoscopic omentobursopancreatostomy was performed in 8.8% of patients. Relaparoscopy in 14.7% of cases was combined with minilumbotomy and omentobursostomy (Figure 1). After performing 20 surgical interventions out of 24, using minimally invasive technologies and traditional relaparotomy (n=4), purulent-septic complications were noted in 20.8% of cases with a 12.5% fatal outcome. In patients in the control group, complications were noted in 40%, with a 30% death rate.
Conclusions : According to indications, minimally invasive correction of postoperative pancreatic necrosis is an effective method.
Methods : 34 patients with postoperative pancreatic necrosis were analyzed. Of these, 70.6% were operated on using minimally invasive technologies, 29.4% using the open method. Focal pancreatic necrosis occurred in 41.2% patients, massive - in 35.3%, total-subtotal - in 23.5%. Including in 35.3% of cases, percutaneous drainage interventions were performed in patients of the main group, with pancreatic puncture taken (table 1).
Results : When performing puncture-drainage interventions, importance was attached to the distance from the puncture site on the body surface to the border of the fluid accumulation. Moreover, it ranged from 15 to 130 mm. In 83.3% of cases, puncture-drainage interventions were performed through the anterior abdominal wall; while draining the omental bursa, in 20% of cases a translube paravertebral approach was performed. Histological examination of pancreatic biopsies showed that areas of pancreatic tissue necrosis occupy from 20 to 90% of the specimen area. When examining punctures of liquid formations, it was found that in 9 out of 24 cases, the growth of bacteria from destructive areas of the pancreas was observed. In the remaining 15 cases, there was no growth of bacterial flora. Monoculture was found in 4 out of 9 cases, and in the remaining 55.6% cases an association of bacteria was detected. Relaparoscopic omentobursopancreatostomy was performed in 8.8% of patients. Relaparoscopy in 14.7% of cases was combined with minilumbotomy and omentobursostomy (Figure 1). After performing 20 surgical interventions out of 24, using minimally invasive technologies and traditional relaparotomy (n=4), purulent-septic complications were noted in 20.8% of cases with a 12.5% fatal outcome. In patients in the control group, complications were noted in 40%, with a 30% death rate.
Conclusions : According to indications, minimally invasive correction of postoperative pancreatic necrosis is an effective method.
SESSION
E-poster
E-Session 03/21 ALL DAY