Treatment of patients with chronic pancreatitis complicated by pancreatoragia

Abstract

The aim: To present and share our experience in the treatment of pancreatoragia which could help to prevent pancreatoragia in patients with chronic pancreatitis in the pre- and postoperative period. Materials and methods: Surgical treatment of complicated chronic pancreatitis (CP) was performed on 249 patients in the surgical clinic of the medical faculty №2 of National Pirogov Memorial Medical University of Vinnytsia during 2000 - 2021. Pancreatorrhagia occurred in 6 (2.4%) patients, group A – 3 (1.2%) - as disease manifestation, group B – 3 (1.2%) – as complication after surgery. In group A the source of bleeding was the lower pancreato-duodenal artery: 2 (0.8%) had lower pancreaticoduodenal artery aneurysms with bleeding into the cyst, 1 (0.4%) - a year after previously performed pancreato-duodenal resection. In group B pancreatorrhagia developed in 3 (1.2%) patients after the Frey-Izbitsky local resection of the pancreas: 2 (0.8%) - from pancreato-jejuno anastomosis, 1(0.4%) - from pancreatopleural fistula. Conclusions: Pancreatoragia, as a manifestation of chronic pancreatitis, occurred in 6 (2.4%) patients. Bleeding occurred as a manifestation of the disease in 3 (1.2%) patients and in 3 (1.2%) patients – in the postoperative period. It is possible to use fibrin or cyanoacrylate glue to filling the defect of the pancreatic duct or to suture vessels in the parenchyma of the pancreas by PDS for the prevention of pancreatoragia in the postoperative period.