INDICATORS OF THE EFFECTIVENESS OF THE TREATMENT OF FALSE CYSTS


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Abstract

Objective: to compare the results of treatment of patients with pseudocysts of the pancreas operated by the traditional laparotomy method and using minimally invasive technologies.
Materials and methods of research. A retrospective analysis of the results of treatment of 47 patients with pseudocysts of the pancreas was carried out. Punctures and drainage of pancreatic pseudocysts on the background of pancreatitis, under the control of ultrasound, were performed in 24 patients (main group). 23 patients were subjected to the cavity method of treatment (control group). Indications for laparotomic methods of treatment were considered to be the preservation of clinical manifestations of the disease, purulent discharge from the cyst for 3-4 days after drainage under ultrasound control, the presence of sequesters in the cystic cavity. These patients underwent laparotomy, external cyst drainage, and sequestectomy. The indication for puncture or drainage under ultrasound control was a false pancreatic cyst more than 6 cm in diameter in the absence of signs of sequestration. All patients underwent cytological and bacteriological examination of the fluid evacuated from the cyst, the level of amylase content in it was examined.
Results. The positive effect of treatment was noted in 82.7% of patients using minimally invasive percutaneous techniques (elimination of cysts was achieved in 52.3% of patients, reduction of cyst size - in 30.7%) and in 65.6% of patients treated with traditional laparotomy methods. The average hospital stay in patients of the main group decreased by 12.3 days compared to the control. Intraoperative and postoperative complications were noted in 17.3% of patients in the main group and 34.4% in the control group. The most frequent complications were suppuration (25% of all patients with pseudocysts), bleeding and recurrence of pseudocysts (1.3% and 10.2%, respectively). At the same time, in 96.7% of patients with recurrent pseudocysts in the early postoperative period, the level of intracystic fluid amylase exceeded normal values by 5 or more times.
Conclusions. The effectiveness of the compared minimally invasive surgical methods can be compared with laparotomy methods, while some of the complications in the early postoperative period and the average length of hospital stay with the use of minimally invasive interventions are significantly less (p<0.05). The level of intracystic fluid amylase can serve as a prognostic sign for two-stage treatment.

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Materials and methods of research. A retrospective analysis of the results of treatment of 47 patients with pseudocysts of the pancreas was carried out. Punctures and drainage of pancreatic pseudocysts on the background of pancreatitis, under the control of ultrasound, were performed in 24 patients (main group). 23 patients were subjected to the cavity method of treatment (control group). Indications for laparotomic methods of treatment were considered to be the preservation of clinical manifestations of the disease, purulent discharge from the cyst for 3-4 days after drainage under ultrasound control, the presence of sequesters in the cystic cavity. These patients underwent laparotomy, external cyst drainage, and sequestectomy. The indication for puncture or drainage under ultrasound control was a false pancreatic cyst more than 6 cm in diameter in the absence of signs of sequestration. All patients underwent cytological and bacteriological examination of the fluid evacuated from the cyst, the level of amylase content in it was examined.

Results. The positive effect of treatment was noted in 82.7% of patients using minimally invasive percutaneous techniques (elimination of cysts was achieved in 52.3% of patients, reduction of cyst size - in 30.7%) and in 65.6% of patients treated with traditional laparotomy methods. The average hospital stay in patients of the main group decreased by 12.3 days compared to the control. Intraoperative and postoperative complications were noted in 17.3% of patients in the main group and 34.4% in the control group. The most frequent complications were suppuration (25% of all patients with pseudocysts), bleeding and recurrence of pseudocysts (1.3% and 10.2%, respectively). At the same time, in 96.7% of patients with recurrent pseudocysts in the early postoperative period, the level of intracystic fluid amylase exceeded normal values by 5 or more times.

Conclusions. The effectiveness of the compared minimally invasive surgical methods can be compared with laparotomy methods, while some of the complications in the early postoperative period and the average length of hospital stay with the use of minimally invasive interventions are significantly less (p<0.05). The level of intracystic fluid amylase can serve as a prognostic sign for two-stage treatment

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About the authors

Farangiz Nematilla kizi Jamolova

Samarkand State Medical Institute

Author for correspondence.
Email: jamolova.farangiz1999@gmail.com

Faculty of Medicine 4th year student

Uzbekistan, Uzbekistan, Samarkand region, Samarkand, AMIR TEMUR str., 18.

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