One block

Remove obstruction of RV outflow of secretions in the output section of the main duct can be achieved by dissection and plastics its mouth (virsungoplastiki) laparotomy or endoscopic access. However, during the initial CP narrowing the mouth of the duct is rarely an isolated, often in the course of it, and the smaller ducts are numerous strictures alternating with lakunoobraznymi extensions filled with secrets and stones, in these conditions, the transaction type virsungoplastiki not provide a complete decompression of the pancreatic duct system.

The most reasonable in this situation is the method of longitudinal pancreatojejunostomy in which to jejunum anastomotic all dissected longitudinally gland, providing a free flow of secretion in the intestine of the smallest ducts, thereby reducing the risk of exacerbation of pancreatitis and pain intensity. It is possible to retain maximum insular and acinar tissue cancer, prevent diabetes, improve digestion of food.

In the treatment of CP are also various brand viagra options for pancreatic resection: distal (DR), subtotal, partial resection head cancer with preservation of recreation, and bile duct cancer of the body; pancreatoduodenal (PRD); total duodenopankreatektomiya (TDPE).

Distal resection of prostate as an independent operation that is permissible only in rare cases of pancreatitis, a limited body and tail cancer; DR diffuse CP does not prevent the progression of lesions remainder of the gland, and removing a significant proportion of islet tissue creates the risk of developing diabetes. Therefore, the diffuse calculous HP DR should be completed by imposing a longitudinal chistopancreatojejunoanastomosys to decompress advanced pancreatic duct stump and the prevention of postoperative recurrence of pancreatitis.

Subtotal resection involves removal of one block of the tail, body, and most of the pancreatic head, leaving only a small rim of tissue adjacent to the wall of DC. This operation naturally leads to an almost complete loss of outer-and endocrine functions of pancreas and its use is justified only in exceptional cases, the total defeat of cancer, with the loss of its function.

Pancreatoduodenal resection involves removal of the head gland, DK, often the distal half of the stomach and is pathogenetically justified the operation in complicated CPs with the localization of pathological changes - cirrhosis, litiaza, pseudocysts - a head cancer and involvement in the pathological process common bile duct. The use of organ preservation with the PRD of the stomach and pylorus and a longitudinal anastomosis of pancreatic duct stump with the jejunum decreases the risk of postoperative complications and recurrence of pancreatitis, and allows you to save the residual gland function.

Sectoral resection of pancreatic head includes a series of steps the PRD and the DR with the formation of anastomoses of both pancreatic stump with the jejunum. Such an organ-preserving operations can be accompanied by favorable results [2], but gross anatomical changes in the pancreas and adjacent organs, it is technically impossible.

Total duodenopankreatektomiya (TDPE) used in the most severe cases, diffuse HP if you can not distinguish it from cancer of the head and body of the pancreas, recurrence of pancreatitis in the head gland after DR. After TDPE regularly develop marked functional disorders, but in an advanced stage of CP in the ensuing atrophy of the acinar pancreatic tissue, reducing emissions of enzymes in the intestine replacement therapy easier. Diabetes mellitus after TDPE is viagra advantages unstable and sensitive to insulin due to shutdown insular and kontrinsulyarnoy systems arising hyperglycemia is quickly replaced by hypoglycemic crises, leading to encephalopathy and even death of patients. Especially dangerous is the use of TDPE in individuals with low intelligence, suffering from alcoholism, it is impossible to provide proper medical care and glycemic control.

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