ArticlePrzeglad gastroenterologiczny2018
Peculiarities of diagnostics of billiary hypertension in patients with complicated forms of chronic pancreatitis.
Article in Przeglad gastroenterologiczny, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionThe morbidity of chronic pancreatitis (CP) remains at a high level. In cases of CP, prepapillary stenosis of the common bile duct (CBD) complicates the course of disease in 30-60% of patients.
aimTo improve the detection of biliary hypertension (BH) in patients with complicated forms of CP by increasing the accuracy of preoperative and intraoperative diagnostics using modern diagnostic methods. MATERIAL AND
methodsWe analysed the results of surgical treatment of 573 patients with complicated forms of CP. In 163 (28.5%) patients, CP was complicated by BH. The method of intraoperative monitoring of biliary pressure (IOM BP) was developed and introduced for intraoperative control and determination of the adequacy of intervention regarding biliary decompression.
resultsMechanical jaundice was diagnosed by clinical methods in 101 (61.9%) CP patients with BH, and by laboratory methods in 108 (66.2%) patients. Such methods as magnetic resonance cholangiopancreatography (95.6%), endoscopic retrograde cholangiopancreatography (93.7%), and computed tomography (93.8%) proved to have the highest sensitivity for the diagnostics of BH in cases of CP.
conclusionsThe application of an integrated approach with extensive use of modern non-invasive preoperative methods of assessment allowed an approximation of the reliability of preoperative diagnostics of BH in CP patients to 95.6%. The use of the IOM BP method enables us to increase the sensitivity of intraoperative diagnostics of BH to 97.3% and choose the method of surgical intervention, which significantly reduces the risk of BH recurrence in the distant postoperative period by 15.1% (χ
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