References

oncotomsk

Сибирский онкологический журнал

Siberian journal of oncology

1814-48612312-3168

Tomsk National Research Medical Сепtеr of the Russian Academy of Sciences

10.21294/1814-4861-2024-23-2-82-91

oncotomsk-3040

Research Article

ОБЗОРЫ

REVIEWS

Вопросы и пути их решения при панкреатодуоденальной резекции

Challenges during pancreatoduodenectomy and ways to overcome them

https://orcid.org/0000-0002-4516-1997

Ахметзянов

Ф. Ш.

Akhmetzyanov

F. Sh.

Ахметзянов Фоат Шайхутдинович - доктор медицинских наук, профессор, заведующий кафедрой онкологии, лучевой диагностики и лучевой терапии, ФГБОУ ВО «КГМУ» Минздрава России; руководитель хирургической клиники лечебно-диагностического корпуса 2, ГАУЗ «РКОД» Минздрава Республики Татарстан.

420021, Казань, ул. Бутлерова, 49; 420029, Казань, Сибирский тракт, 29

Author ID (Scopus): 6506033368; Researcher ID (WOS): F-4740-2016

Foat Sh. Akhmetzyanov - MD, Professor, Head of Department of Oncology, Radiation Therapy and Diagnostic Imaging, Kazan State Medical University; Head of Surgical Clinic, Tatarstan Regional Clinical Cancer Center.

49, Butlerov St., Kazan, 420000; 29, Sibirsky trakt, Kazan, 420029

Author ID (Scopus): 6506033368; Researcher ID (WOS): F-4740-2016

https://orcid.org/0000-0002-2811-0549

Котельников

А. Г.

Kotelnikov

A. G.

Котельников Алексей Геннадьевич - доктор медицинских наук, профессор, ведущий научный сотрудник отделения абдоминальной онкологии № 2 (опухолей гепатопанкреатобиллиарной зоны).

15522, Москва, Каширское шоссе, 23

Author ID (Scopus): 7005528750

Aleksey G. Kotelnikov - MD, Professor, Leading Researcher, Department of Abdominal Oncology No. 2 (tumors of the hepatopancreatobiliary zone), N.N. Blokhin National Medical Research Center of Oncology оf the Ministry of Health of Russia.

23, Kashirskoe shosse, moscow, 115522

Author ID (Scopus): 7005528750

https://orcid.org/0000-0002-0042-1150

Тер-Ованесов

М. Д.

Ter-Ovanesov

M. D.

Тер-Ованесов Михаил Дмитриевич - доктор медицинских наук, профессор, ведущий научный сотрудник отделения абдоминальной онкологии № 2 (опухолей гепатопанкреатобиллиарной зоны), ФГБУ «НМИЦ онкологии им. Н.Н. Блохина» Минздрава России; заведующий кафедрой онкологии и гематологии, ФГБОУ ВО «Российский университет медицины» Минздрава России.

115522, Москва, Каширское шоссе, 23; 127006, Москва, ул. Долгоруковская, 4

Author ID (Scopus): 6507566208

Mikhail D. Ter-Ovanesov - MD, Professor, Leading Researcher, Department of Abdominal Oncology No. 2 (tumors of the hepatopancreatobiliary zone), N.N. Blokhin National Medical Research Center of Oncology оf the Ministry of Health of Russia; Head of the Department of Oncology and Hematology, Russian University of Medicine of the Ministry of Health of Russia.

23, Kashirskoe shosse, Moscow, 115522; 4, Dolgorukova St., Moscow, 127006

Author ID (Scopus): 6507566208

https://orcid.org/0000-0002-6603-1390

Егоров

В. И.

Egorov

V. I.

Егоров Василий Иванович - кандидат медицинских наук, ассистент кафедры онкологии, лучевой диагностики и лучевой терапии, ФГБОУ ВО «КГМУ» Минздрава России; врач-онколог онкологического отделения, ГАУЗ «РКОД» Минздрава Республики Татарстан.

420021, Казань, ул. Бутлерова, 49; 420029, Казань, Сибирский тракт, 29

Researcher ID (WOS): P-3359-2017; Author ID (Scopus): 57194534032

Vasiliy I. Egorov - MD, PhD, Assistant, Department of Oncology, Radiation Therapy and Diagnostic Imaging, Kazan State Medical University; Oncologist, Department of Oncology, Tatarstan Regional Clinical Cancer Center.

49, Butlerov St., Kazan, 420000; 29, Sibirsky trakt, Kazan, 420029

Researcher ID (WOS): P-3359-2017; Author ID (Scopus): 57194534032

drvasiliy21@gmail.com

https://orcid.org/0000-0001-7031-4206

Гостюнин

Т. Д.

Gostyunin

T. D.

Гостюнин Тимур Дмитриевич – студент.

420021, Казань, ул. Бутлерова, 49

Timur D. Gostyunin - student, Kazan State Medical University.

49, Butlerov St., Kazan, 420000

https://orcid.org/0009-0004-3005-9545

Карпеева

О. А.

Karpeeva

O. A.

Карпеева Ольга Александровна – врач.

420029, Казань, Сибирский тракт, 29

Olga A. Karpeeva - MD, Tatarstan Regional Clinical Cancer Center.

29, Sibirsky trakt, Kazan, 420029

ФГБОУ ВО «Казанский государственный медицинский университет» Минздрава России; ГАУЗ «Республиканский клинический онкологический диспансер» Минздрава Республики ТатарстанРоссияKazan State Medical University; Tatarstan Regional Clinical Cancer CenterRussian Federation

ФГБУ «Национальный медицинский исследовательский центр онкологии им. Н.Н. Блохина» Минздрава РоссииРоссияN.N. Blokhin National Medical Research Center of Oncology оf The Ministry of Health of RussiaRussian Federation

ФГБУ «Национальный медицинский исследовательский центр онкологии им. Н.Н. Блохина» Минздрава России; ФГБОУ ВО «Российский университет медицины» Минздрава РоссииРоссияN.N. Blokhin National Medical Research Center of Oncology оf The Ministry of Health of Russia; Russian University of Medicine of The Ministry of Health of RussiaRussian Federation

ФГБОУ ВО «Казанский государственный медицинский университет» Минздрава РоссииРоссияKazan State Medical UniversityRussian Federation

ГАУЗ «Республиканский клинический онкологический диспансер» Минздрава Республики ТатарстанРоссияTatarstan Regional Clinical Cancer CenterRussian Federation

2024

12052024

2328291

2024

Ахметзянов Ф.Ш., Котельников А.Г., Тер-Ованесов М.Д., Егоров В.И., Гостюнин Т.Д., Карпеева О.А.

Akhmetzyanov F.S., Kotelnikov A.G., Ter-Ovanesov M.D., Egorov V.I., Gostyunin T.D., Karpeeva O.A.

Данная работа распространяется под лицензией Creative Commons Attribution 4.0.

This work is licensed under a Creative Commons Attribution 4.0 License.

https://www.siboncoj.ru/jour/article/view/3040

Актуальность. Панкреатодуоденальная резекция (ПДР) является основным видом хирургического лечения злокачественных опухолей головки поджелудочной железы, дистальной части холедоха, двенадцатиперстной кишки и Фатерова сосочка. Данная операция сопряжена с высоким риском осложнений, развитию которых способствуют разные факторы. Поскольку, панкреатическая фистула является ключевым осложнением ПДР, то особенно важным становится выбор способа формирования панкреатического анастомоза. Материал и методы. Поиск литературных источников, опубликованных с января 1980 г. по январь 2024 г., производился в системах Pubmed, Elibrary. Из 2 300 найденных источников для написания обзора использованы 69. Включены данные как ретроспективных, так и проспективных клинических исследований, посвященных панкреатодуоденальным резекциям при злокачественных новообразованиях, сложностям, которые встречаются при данной операции, и путям их решения. Обобщен опыт зарубежных и отечественных авторов. Результаты. Существует более 60 вариантов панкреатодигестивного анастомоза, что свидетельствует об отсутствии универсального метода, обеспечивающего профилактику панкреатического свища. На результаты лечения могут влиять характер неоадъювантного лечения, сопутствующие заболевания, анатомические особенности и состояние железы, наличие механической желтухи и способы ее разрешения. Рассмотрены основные механизмы негативных факторов, влияющих на развитие осложнений. Индивидуальный подход к пациенту с учетом всех факторов позволяет значительно снизить риск осложнений.

Background. Pancreaticoduodenal resection (PDR) is the surgical procedure for cancer of the head of the pancreas, distal common bile duct, duodenum and ampulla of Vater. This surgery is associated with a high risk of complications, the development of which can be influenced by various factors. since pancreatic fistula is a key complication of PDR, the choice of the method for pancreatic anastomosis becomes especially important. Material and methods. The search for publications was carried out using the PubMed and Elibrary systems from January 1980 to January 2024. of the 2,300 sources found, 69 were used to write the review. We included data from both retrospective and prospective clinical trials that were devoted to pancreatoduodenectomy for malignant neoplasms, the difficulties encountered in performing this surgery and ways to solve them. Results. Currently, there are more than 60 types of pancreatico-digestive anastomosis, which indirectly indicates the absence of a universal one that ensures the prevention of pancreatic fistula. The treatment outcomes may be influenced by the nature of neoadjuvant treatment, concomitant diseases, anatomical features, presence of obstructive jaundice and methods of its relief. The main mechanisms of influence of negative factors on the development of complications are considered. an individual approach to the patient, taking into account all factors, can significantly reduce the risk of complications.

рак поджелудочной железырак холедохарак большого дуоденального сосочкапанкреатодуоденальная резекцияоперация Уипплапанкреатический свищпанкреатодигестивный анастомоз

pancreatic cancercommon bile duct cancercancer of the major preudenal papillapancreatoduodenectomyWhipple operationpancreatic fistulapancreatodigestive

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The authors declare that there are no conflicts of interest present.