Murat ZEYTUNLU, Murat AYNACI, Özgür FIRAT, Deniz NART, Oktay TEKEŞİN, Refik KİLLİ, Yıldıray YÜZER

Kronik pankreatitte yaşam kalitesini yükseltmek için rezektif cerrahi

Giriş ve amaç: Bu çalışma, kronik pankreatit nedeni ile rezektif cerrahi uygulanan hastalarda cerrahinin, yaşam kalitesine etkisi ile birlikte kısa dönem sağ kalıma etkisini değerlendirme amacıyla yapılmıştır. Gereç ve yöntem: Ocak 1995-Mayıs 2003 arasında Ege Üniversitesi Tıp Fakültesi Hastanesi Genel Cerrahi Ana Bilim Dalı Hepatopankreatobilier Birimi'nde 18 hastaya kronik pankreatit nedeni ile pankreas rezeksiyonu uygulandı. Hastalığın etyolojisi, semptomları, tanı yöntemleri, cerrahi endikasyonlar, uygulanan cerrahi prosedür, hastanede kalış süresi ile birlikte kısa dönem sağ kalım analiz edildi. Bulgular: Kronik pankreatit nedenleri; 10 hastada alkol, 8 hastada idiopatik olarak belirlendi. En sık görülen semptomlar karın ağrısı, sarılık, bulantı ve kusma, kilo kaybı ve diare olarak saptandı. Hastalarda özgeçmişte en sık izlenen komorbiditenin diabetes mellitus olduğu izlendi. Tüm hastalara pankreas rezeksiyonu uygulandı. 10 hastaya (%55) pankreatikoduodenektomi, 4 hastaya distal pankreatektomi (%22.5), 4 hastaya medial pankreatektomi (%22.5) uygulandı. Ortalama hastanede kalım süresi 10 gün (5-20 gün) ve ortalama izlem süresi 32 ay (4-60 ay) idi. Bu periyotta mortal seyreden olgumuz olmadı. Hiçbir hastada uzun dönemde analjezik verme gereksinimi duyulmadı, ancak tüm hastalara ekzokrin pankreas fonksiyonu için tıbbi tedavi verildi. Sonuç: Elde ettiğimiz veriler gözönüne alındığında hayat kalitesinde belirgin bir düzelme yaratan rezektif cerrahiyi kronik pankreatitli hastaların tedavisinde önemli bir seçenek olarak sunmaktayız.

Anahtar Kelimeler:

Kronik pankreatit, rezektif cerrahi, hayat kalitesi

Pancreatic resection for quality of life in chronic pancreatitis

Background/aim: This study was done to investigate the impact of resective surgery due to chronic pancreatitis on patients' short-term survival and life quality. Materials and methods: Between January 1994 and May 2003, 18 patients were operated due to chronic pancreatitis in Ege University Medical Faculty, Department of General Surgery, Hepatopancreatobiliary Unit. The etiologies, symptoms, diagnostic methods, surgical indications, surgical procedures, and duration of hospitalization were analyzed in relation to short-term survival. Results: The etiologies of chronic pancreatitis were alcohol in 10 patients, and idiopathic in 8 patients. The most common symptoms were abdominal pain, jaundice, fatigue, vomiting, weight loss and diarrhea. The most common comorbidity observed in patients was diabetes mellitus. All of the patients underwent pancreatic resection. Ten patients underwent pacreaticoduodenectomy (55%), 4 patients distal pancreatectomy (22.5%), and 4 patients medial pancreatectomy (22.5%). The median hospital stay was 10 days (5-20) and the median follow-up was 32 months (4-60 months). None of the patients required analgesic treatment as a further treatment, though all were given medical treatment for the exocrine function of the pancreas. Conclusion: Considering the data collected, we propose pancreatic resection in chronic pancreatitis patients as an important modality of treatment in view of its contribution to better life quality.

Keywords:

Chronic pancreatitis, resective surgery, quality of life,

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