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Classification criteria of chronic pancreatitis

Journal: I.P. Pavlov Russian Medical Biological Herald (Vol.24, No. 1)

Publication Date:

Authors : ; ; ; ; ; ; ; ; ; ;

Page : 91-97

Keywords : chronic pancreatitis; classification; surgical tactics;

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This is the analysis of the most widespread classification of chronical pancreatitis and the results of retrospective distribution of 120 patients. In our article the review of the main actual classifications of chronic pancreatitis is executed. Our own classification is presented. The authors suppose that the volume of the surgical intervention in most cases is determined by morphological alterations in the pancreas. The most important changes are affections of pancreas parenchyma (criterion “P”), large cavities (criterion “C”), and widening of Wirsung's duct (criterion “H”). Such king of morphology is evidence for transferring a patient to a surgical department. Its assessment together with clinical signs determines expediency of operation. The method of surgical treatment depends on the localization and the combination of morphological changes. Existence of the positive criterion "Р" in combination with a constant or recidivous pain syndrome demands performance of a resection of a head of a pancreas. Existence of a large extrapancreatic cyst assumes preliminary mini-invasive treatment with the subsequent assessment of a condition of a parenchyma and expressiveness of clinic of pancreatitis. Expansion of the main pancreatic duct - the criterion of "H" refers to the need for wide opening duct during resection of the pancreas. So, the choice of surgical technique in a particular clinical situation depends on many factors, but in most cases, the amount of operation is determined by morphological changes in the pancreas. We created the classification considering morphological criteria. Efficiency of this scheme confirms the analysis of the remote results of surgical treatment of patients with chronic pancreatitis.

Last modified: 2017-01-27 21:45:52