Endoscopic papillectomy and endoscopic papillosphincterotomy for benign diseases of the major duodenal papilla
Journal Title: Хірургія України - Year 2018, Vol 0, Issue 4
Abstract
The aim — to evaluate the possibility of clinical application of the major duodenal papilla resection by endoscopic techniques for various diseases. Materials and methods. 32 patients with benign stenosis and benign tumours of major duodenal papilla were treated in 2014 — 2017. Of these, 10 (31.25 %) women and 22 (68.75 %) men were between the ages of 36 and 64, the average age were 52 years. Depending on the nature of major duodenal papilla (MDP) lesions and their endoscopic treatment types, patients with MDP disease were divided into two groups: first group — 21 patients (65.6 %) with benign stenosis of the MDP and the second group with 11 patients (34.3 %) with benign tumours of MDP. Loop electro excision was performed in 9 patients, a combination of loop electroexcitation with sphincterotomy (EST) was performed in 13 patients, a combination of endoscopic papillectomy (EP) with argon‑plasma destruction in 6 patients, a combination of EP and electrical destruction in 5 patients. Endoprosthesis of the common bile duct was performed in 9 patients, 4 patients underwent endoprosthetics of the pancreatic duct, and endoprosthetics of both ducts were performed in 19 patients. Results and discussion. Complications were noted in 9 (28.1 %) patients. In the long‑term period, all patients are alive, functional disorders of the organs were not revealed. Conclusions. Endoscopic examination allows to determine the visual signs of MDP lesions (the papilla tissue changes). The diagnostic efficiency of ERCPG was 81.5 %. Clinical experience has shown that EPST can significantly reduce the number of repeated surgical operations on the biliary tract and significantly reduce the incidence of postoperative complications and mortality rate in patients with hepatopancreatoduodenal area pathology.
Authors and Affiliations
V. P. Slobodiannyk, V. A. Zosym, D. A. Ragushyn, Yu. Yu. Voievoda, A. P. Kurilenko, K. D. Tkach
Keywords
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- EP ID EP452015
- DOI 10.30978/SU2018-4-25
- Views 123
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