LAPAROSCOPIC PROCEDURES IN CHILDREN WITH PANCREATIC PSEUDOCYSTS



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Abstract

Introduction. Pancreatic pseudocysts are encapsulated fluid sacs in the omentum having no epithelial lining; they appear in the pancreas after injury and inflammation. Recently, there has appeared a trend to treat pancreatic pseudocysts with laparoscopic surgical interventions. The article describes laparoscopic treatment of pancreatic pseudocysts in 10 children. Objective. To evaluate the effectiveness of laparoscopic interventions in children with pseudocysts in the pancreas. Material and methods. In 2013-2018, 10 laparoscopic surgeries in children, aged 4-17 (5 boys and 5 girls), with pancreatic pseudocysts were performed at the department of pediatric surgery in the Russian Medical Academy of Continuous Professional Education. Indications for surgery were: pancreatic pseudocysts having diameter more than 6 cm and wall thickness more than 3-4 mm, no effect after the conservative therapy , cyst formation more than 3 months, persistent pain syndrome. Results. The choice of a surgical technique was defined by pseudocyst etiology and location. The children had six laparoscopic cystoeunoanastomoses, two partial cystectomies with a distal pancreatojejunoanastomosis and two partial cystectomies with a longitudinal pancreatojejunoanastomosis when the cyst was formed at the chronic pancreatitis. No intraoperative complications were seen. Early postoperative complications occurred in 2 patients: an external pancreatic fistula at the drainage site (1) and intestinal obstruction (1) at the level of the intestinal anastomosis. Conclusion. Laparoscopic surgeries in children with pancreatic pseudocysts are effective and less traumatic. The laparoscopic technique allows to make a complete revision, to perform sequestrnecrectomy , if necessary, as well as to take the material for histological examination and to ensure a reliable long-term drainage.

About the authors

Yu. Yu. Sokolov

Russian Medical Academy of Post-Graduate Education

Author for correspondence.
Email: noemail@neicon.ru
Россия

A. M. Efremenkov

Russian Medical Academy of Post-Graduate Education; Central Clinical Hospital with the clinic of the Management Affair of President Russian Federation

Email: efremart@mail.ru
Россия

G. T. Tumanian

Russian Medical Academy of Post-Graduate Education

Email: noemail@neicon.ru
Россия

M. K. Akopyan

Saint Vladimir Children’s Municipal Clinical Hospital

Email: noemail@neicon.ru
Россия

A. N. Shapkina

Pacific State Medical University

Email: noemail@neicon.ru
Россия

R. A. Akhmatov

Russian Medical Academy of Post-Graduate Education

Email: noemail@neicon.ru
Россия

D. V. Antonov

Perm State Medical University named after E.A. Wagner

Email: noemail@neicon.ru
Россия

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