57 results on '"Victor Tsvirkun"'
Search Results
2. Laparoscopic versus open Frey procedure: Comparative analysis of short and long-term outcomes
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Igor Khatkov, Roman Izrailov, Victor Tsvirkun, Ruslan Alikhanov, Oleg Vasnev, Tatiana Dyuzheva, Viacheslav Egorov, Kamil Dalgatov, Magomet Baychorov, Paul Agami, and Aleksey Andrianov
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Hepatology ,Endocrinology, Diabetes and Metabolism ,Gastroenterology - Published
- 2022
3. Coupling optimized bending-insensitive multi-core fibers for lensless endoscopy
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Naveen Gajendra Kumar, Siddharth Sivankutty, Victor Tsvirkun, Andy Cassez, Damien Labat, Rosa Cossart, Geraud Bouwmans, Esben Ravn Andresen, Hervé Rigneault, Institut FRESNEL (FRESNEL), Aix Marseille Université (AMU)-École Centrale de Marseille (ECM)-Centre National de la Recherche Scientifique (CNRS), MOSAIC (MOSAIC), Aix Marseille Université (AMU)-École Centrale de Marseille (ECM)-Centre National de la Recherche Scientifique (CNRS)-Aix Marseille Université (AMU)-École Centrale de Marseille (ECM)-Centre National de la Recherche Scientifique (CNRS), Laboratoire de Physique des Lasers, Atomes et Molécules - UMR 8523 (PhLAM), Université de Lille-Centre National de la Recherche Scientifique (CNRS), Institut de Neurobiologie de la Méditerranée [Aix-Marseille Université] (INMED - INSERM U1249), and Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)
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[PHYS.PHYS.PHYS-OPTICS]Physics [physics]/Physics [physics]/Optics [physics.optics] ,Atomic and Molecular Physics, and Optics - Abstract
International audience; We report a bending-insensitive multi-core fiber (MCF) for lensless endoscopy imaging with modified fiber geometry that enables optimal light coupling in and out of the individual cores. In a previously reported bending insensitive MCF (twisted MCF), the cores are twisted along the length of the MCF allowing for the development of flexible thin imaging endoscopes with potential applications in dynamic and freely moving experiments. However, for such twisted MCFs the cores are seen to have an optimum coupling angle which is proportional to their radial distance from the center of the MCF. This brings coupling complexity and potentially degrades the endoscope imaging capabilities. In this study, we demonstrate that by introducing a small section (1 cm) at two ends of the MCF, where all the cores are straight and parallel to the optical axis one can rectify the above coupling and output light issues of the twisted MCF, enabling the development of bend-insensitive lensless endoscopes.
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- 2023
4. Combining E-PASS model and disease specific risk factors to predict severe morbidity after liver and bile duct resection for perihilar cholangiocarcinoma
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I. Kazakov, O. V. Melekhina, A. Koroleva, Mikhail Efanov, Y. Kulezneva, E. Zamanov, A. Vankovich, Ruslan Alikhanov, and Victor Tsvirkun
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Disease specific ,medicine.medical_specialty ,Multivariate analysis ,Surgical stress ,030230 surgery ,Cholangiocarcinoma ,03 medical and health sciences ,Postoperative Complications ,0302 clinical medicine ,Risk Factors ,medicine ,Hepatectomy ,Humans ,Radical surgery ,Retrospective Studies ,Framingham Risk Score ,Hepatology ,Bile duct ,business.industry ,Gastroenterology ,Perioperative ,medicine.anatomical_structure ,Bile Duct Neoplasms ,Liver ,030220 oncology & carcinogenesis ,Bile Ducts ,Radiology ,Morbidity ,Complication ,business ,Klatskin Tumor - Abstract
Estimation of physiologic ability and surgical stress system (E-PASS) has been shown to be effective in predicting morbidity after surgery for perihilar cholangiocarcinoma (PHCC). Nevertheless, E-PASS does not include an assessment of the disease specific risk factors. The aim of the study was to estimate the combined impact of E-PASS and specific preoperative factors on major morbidity for PHCC patients.A retrospective analysis of a prospectively collected data was performed. Severe morbidity according to complication comprehensive index was defined as ≥40 points. A value of comprehensive risk score (CRS) ≥1 was taken as critical.Multivariate analysis of perioperative data from 122 patients revealed significant impact of five factors (CRS ≥1, future liver remnant volume50%, T4 stage, moderate and severe cholangitis, INR) on the risk of severe morbidity after resection. The AUC for the combination of these factors was classified as good predictive value (0.810, 95% CI 0.729-0.891) and poor predictive value (0.673, 95% CI 0.573-0.773) for CRS alone (p = 0.040).A combination of E-PASS with disease specific risk factors is a reliable predictive model for major morbidity for patients undergoing radical surgery for PHCC.
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- 2021
5. Laparoscopic radical and conservative surgery for hydatid liver echinococcosis: PSM based comparative analysis of immediate and long-term outcomes
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O. V. Melekhina, Victor Tsvirkun, Mikhail Efanov, I. Kazakov, Ruslan Alikhanov, D. Salimgereeva, Zubaydullo Azizzoda, A. Vankovich, Yulia Kulezneva, Kurbonov Karimkhon, Natalia Elizarova, and Alena Chitadze
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Laparoscopic surgery ,Echinococcosis, Hepatic ,medicine.medical_specialty ,medicine.medical_treatment ,030230 surgery ,Cystectomy ,03 medical and health sciences ,0302 clinical medicine ,Recurrence ,Internal medicine ,Humans ,Medicine ,Radical surgery ,Retrospective Studies ,Laparoscopic cystectomy ,business.industry ,Retrospective cohort study ,Hepatology ,medicine.disease ,Echinococcosis ,Surgery ,Laparoscopy ,030211 gastroenterology & hepatology ,Neoplasm Recurrence, Local ,business ,Abdominal surgery - Abstract
The diffusion of laparoscopic radical surgery for hydatid liver echinococcosis remains limited. There are no published data on a comparative analysis of the immediate and long-term results of radical and conservative laparoscopic surgery for liver hydatid cysts. Comparison of the immediate and long-term outcomes after laparoscopic radical and conservative cystectomies was aimed. HPB center (Center 1) and general surgery hospital in an endemic area (Center 2) participated in a retrospective study. Radical surgery included total, subtotal pericystectomy, and liver resection. Conservative surgery comprised cystectomy without/with partial pericystectomy. The total number of patients who underwent surgery for liver hydatid cysts was 213. Laparoscopic cystectomy was performed in 106 (50%) patients. This number included 47 radical laparoscopic cystectomy (Center 1). Conservative laparoscopic procedures were used in 59 patients (Center 2). Finally, twenty-seven pairs of patients were matched. Immediate outcomes were better for radical treatment in terms of severe morbidity, length of hospital stay, and time of abdominal drainage before and after PSM. The mean follow-up length was 23 (4–66) and 29 (6–66) months and the recurrence rate was 2% and 5% in groups of radical and conservative treatment respectively. No differences were found in 1-, 3-, and 5-year disease free survival. After second PSM for recurrence, 20 pairs were matched with no relapse of disease. Laparoscopic radical surgery leads to the better immediate outcomes and can be recommended as the preferred treatment option in a specialized HPB center. Conservative option is justified in general hospitals in endemic area for selected uncomplicated cysts.
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- 2021
6. High-resolution two-photon, three-photon, Harmonic generations and CARS flexible endo-microscope
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Vasyl Mytskaniuk, Septier, D., Gaëlle Brevalle, Victor Tsvirkun, Fabert Marc, Géraud Bouwmans, Frédéric Louradour, Kudlinski, A., Hervé RIGNEAULT, Institut FRESNEL (FRESNEL), Aix Marseille Université (AMU)-École Centrale de Marseille (ECM)-Centre National de la Recherche Scientifique (CNRS), Laboratoire de Physique des Lasers, Atomes et Molécules - UMR 8523 (PhLAM), Université de Lille-Centre National de la Recherche Scientifique (CNRS), XLIM (XLIM), Université de Limoges (UNILIM)-Centre National de la Recherche Scientifique (CNRS), MOSAIC (MOSAIC), Aix Marseille Université (AMU)-École Centrale de Marseille (ECM)-Centre National de la Recherche Scientifique (CNRS)-Aix Marseille Université (AMU)-École Centrale de Marseille (ECM)-Centre National de la Recherche Scientifique (CNRS), and Lightcore Technologies (LCT)
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[SPI.OPTI]Engineering Sciences [physics]/Optics / Photonic ,ComputingMilieux_MISCELLANEOUS - Abstract
International audience
- Published
- 2022
7. Miniature 120-beam coherent combiner with 3D printed optics for multicore fiber based endoscopy
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Gaelle Brévalle, Siddharth Sivankutty, Géraud Bouwmans, Naveen Gajendra Kumar, Hervé Rigneault, Andrea Bertoncini, Esben Ravn Andresen, Carlo Liberale, Victor Tsvirkun, Institut FRESNEL (FRESNEL), Aix Marseille Université (AMU)-École Centrale de Marseille (ECM)-Centre National de la Recherche Scientifique (CNRS), MOSAIC (MOSAIC), Aix Marseille Université (AMU)-École Centrale de Marseille (ECM)-Centre National de la Recherche Scientifique (CNRS)-Aix Marseille Université (AMU)-École Centrale de Marseille (ECM)-Centre National de la Recherche Scientifique (CNRS), King Abdullah University of Science and Technology (KAUST), Laboratoire de Physique des Lasers, Atomes et Molécules - UMR 8523 (PhLAM), Université de Lille-Centre National de la Recherche Scientifique (CNRS), ANR-20-CE19-0028,NAIMA,Imagerie rapide et non invasive par fibre optique multi-modes(2020), Centre National de la Recherche Scientifique (CNRS)-École Centrale de Marseille (ECM)-Aix Marseille Université (AMU), and Centre National de la Recherche Scientifique (CNRS)-École Centrale de Marseille (ECM)-Aix Marseille Université (AMU)-Centre National de la Recherche Scientifique (CNRS)-École Centrale de Marseille (ECM)-Aix Marseille Université (AMU)
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Optics and Photonics ,3d printed ,Materials science ,Physics::Optics ,FOS: Physical sciences ,02 engineering and technology ,Applied Physics (physics.app-ph) ,Multicore fiber ,01 natural sciences ,Endoscopy, Gastrointestinal ,010309 optics ,Footprint (electronics) ,Optics ,Optical imaging ,0103 physical sciences ,medicine ,Fiber bundle ,ComputingMilieux_MISCELLANEOUS ,Endoscopes ,Photons ,medicine.diagnostic_test ,business.industry ,Endoscopy ,Physics - Applied Physics ,021001 nanoscience & nanotechnology ,Atomic and Molecular Physics, and Optics ,Bundle ,Printing, Three-Dimensional ,[SPI.OPTI]Engineering Sciences [physics]/Optics / Photonic ,0210 nano-technology ,business ,Beam (structure) ,Physics - Optics ,Optics (physics.optics) - Abstract
We report high efficiency, miniaturized, ultra-fast coherent beam combining with 3D printed micro-optics directly on the tip of a multicore fiber bundle. The highly compact device foot-print (180 micron diameter) facilitates its incorporation into a minimally invasive ultra-thin nonlinear endoscope to perform two-photon imaging, Comment: Published in Optics Letters
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- 2022
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8. Expanding indications for laparoscopic parenchyma-sparing resection of posterosuperior liver segments in patients with colorectal metastases: comparison with open hepatectomy for immediate and long-term outcomes
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Mikhail Efanov, Rutkin Io, A. Vankovich, A. Koroleva, D. Kovalenko, I. Kazakov, Ruslan Alikhanov, Victor Tsvirkun, and Granov Da
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Chemotherapy ,medicine.medical_specialty ,business.industry ,medicine.medical_treatment ,Hepatology ,Surgery ,Resection ,03 medical and health sciences ,0302 clinical medicine ,030220 oncology & carcinogenesis ,Internal medicine ,Parenchyma ,Propensity score matching ,medicine ,030211 gastroenterology & hepatology ,In patient ,Hepatectomy ,business ,Abdominal surgery - Abstract
Laparoscopic liver resection (LLR) of posterosuperior segments (PSS) is still technically demanding procedure for highly selective patients. There is no long-term survival comparative estimation after LLR and open liver resection (OLR) for colorectal liver metastases (CRLM) located in PSS. We aimed to compare long-term overall (OS) and disease-free survival (DFS) after parenchyma-sparing LLR with expanding indications and open liver resection (OLR) of liver PSS in patients with CRLM. Two Russian centers took part in the study. Patients with missing data, hemihepatectomy and extrahepatic tumors were excluded. One of contraindications for LLR was suspicion for tumor invasion in large hepatic vessels. Logistic regression was used for 1:1 propensity score matching (PSM). PSS were resected in 77 patients, which accounted for 42% of the total number of liver resections for CRLM. LLR were performed in 51 (66%) patients. Before and after matching, no differences were found between groups in the following factors: median size of the largest metastatic tumor; proximity to the large liver vessels; the rate of anatomical parenchyma sparing resection of PSS; a positive response to chemotherapy before and after surgery. Regardless of matching, the size of the largest metastases was above 50 mm in more than one-third of patients who received LLR. Before matching, intraoperative blood loss, ICU stay and hospital stay were significantly greater in the group of OLR. No 90-day mortality was observed within both groups. There were no differences in long-term oncological outcomes: 5-year OS after PSM was 78% and 63% after LLR and OLR, respectively; 4-year DFS after PSM was 27% in both groups. Laparoscopic parenchyma-sparing resection of PSS for CRLM are justified in majority of patients who have an indication for OLR if performed in high volume specialized centers expertized in laparoscopic liver surgery.
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- 2020
9. Disputable issues of biliary drainage procedures in malignant obstructive jaundice
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O. V. Melekhina, A. Yu. Ogneva, Ruslan Alikhanov, A. B. Musatov, Yu. V. Kulezneva, Mikhail Efanov, and Victor Tsvirkun
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Medical institution ,Biliary drainage ,medicine.medical_specialty ,Hepatology ,business.industry ,Optimal treatment ,Gastroenterology ,Surgery ,Medicine ,Treatment strategy ,Tumor type ,Obstructive jaundice ,Biliary decompression ,Drainage ,business - Abstract
Currently, the strategy for preoperative management of patients with malignant obstructive jaundice is not defined. The indications for biliary drainage procedures, the choice of biliary drainage technique and duration of preoperative drainage are still disputable. Analysis of international trials revealed that routine preoperative biliary drainage procedures are not recommended. The indications for biliary drainage in resectable tumors are determined considering severity of obstructive jaundice, cholangitis, dates of major surgery and Bismuth-Corlette tumor type in case of proximal biliary stricture. The choice of retrograde or antegrade preoperative biliary drainage depends on the type of biliary stricture (distal or proximal) and possibilities of medical institution. The majority of studies showed that retrograde (endoscopic) biliary drainage procedures are preferred for distal strictures, antegrade (transhepatic) – for proximal ones. Duration of preoperative biliary drainage depends on normalization of biochemical values. Prolonged drainage may be followed by increased incidence of early postoperative complications. The optimal period of preoperative biliary drainage is 2 weeks. It is necessary to determine the causes of obstructive jaundice as early as possible for successful treatment. This is also essential to define optimal treatment strategy in certain case. Advisability and certain technique of biliary decompression should be determined in accordance with the chosen treatment strategy.
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- 2019
10. Percutaneous radiofrequency‐assisted liver partition versus portal vein embolization before hepatectomy for perihilar cholangiocarcinoma
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Mikhail Efanov, O. V. Melekhina, I. Kazakov, Y. Kulezneva, Victor Tsvirkun, A. Vankovich, A. Koroleva, Ruslan Alikhanov, and Igor Khatkov
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Adult ,Male ,medicine.medical_specialty ,Percutaneous ,medicine.medical_treatment ,lcsh:Surgery ,030230 surgery ,Muscle hypertrophy ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Hepatectomy ,Humans ,Stage (cooking) ,Perihilar Cholangiocarcinoma ,Aged ,business.industry ,Surrogate endpoint ,Portal Vein ,Liver failure ,General Medicine ,lcsh:RD1-811 ,Original Articles ,Middle Aged ,Embolization, Therapeutic ,Surgery ,Survival Rate ,Treatment Outcome ,Bile Duct Neoplasms ,Liver ,030220 oncology & carcinogenesis ,HPB ,Case-Control Studies ,Portal vein embolization ,Original Article ,Female ,business ,Klatskin Tumor - Abstract
Background Percutaneous radiofrequency‐assisted liver partition with portal vein embolization in staged liver resection (PRALPPS) represents an alternative to portal vein embolization (PVE) followed by major liver resection in patients with perihilar cholangiocarcinoma. Methods This was an observational case–control study. Both procedures were applied in patients with a future liver remnant (FLR) volume of less than 40 per cent. The main end points of the study were short‐term morbidity and mortality for the two procedures. The study also compared the efficacy of the preresection phases estimated by kinetic growth rate (KGR), time interval and degree of hypertrophy of the FLR. Results The first phase (preresection) was completed in 11 and 18 patients, and the second phase (resection) in nine and 14 patients, in the PRALPPS and PVE groups respectively. Major morbidity after the first stage did not differ between the groups. There were no differences in blood loss, severe morbidity or liver failure rate after the second stage, with no deaths. The mean KGR of the FLR after the preresection phase for PRALPPS was 3·8 (0·6–9·8) per cent/day, and that after PVE was 1·8 (0–6·7) per cent/day (P = 0·037). The mean time interval for FLR hypertrophy in the PRALPPS and PVE groups was 15 (6–29) and 20 (8–35) days respectively (P = 0·039). Conclusion Short‐term outcomes were similar for PRALPPS and PVE in terms of safety. Remnant hypertrophy was achieved more rapidly by PRALPPS., Percutaneous radiofrequency‐assisted liver partition with portal vein embolization in staged liver resection (PRALPPS), modIfied ALPPS with reduced surgical trauma on the first stage, was used in 11 patients with perihilar cholangiocarcinoma. PRALPPS did not differ from portal vein embolization (PVE) in terms of morbidity or mortality. The kinetic growth rate and mean time interval for future liver remnant hypertrophy in the PRALPPS group were significantly better than those in the PVE group. Similar complication rates and outcomes
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- 2019
11. [Poorly cohesive gastric carcinoma. Validity of using the term; translation variants]
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S.G. Khomeriki, I. E. Khatkov, N.S. Karnaukhov, Victor Tsvirkun, I.S. Derizhanova, A.A. Mantsov, and R.E. Izrailov
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Oncology ,medicine.medical_specialty ,business.industry ,Cancer ,Gastric carcinoma ,Adenocarcinoma ,medicine.disease ,Pathology and Forensic Medicine ,Term (time) ,Russia ,Causes of cancer ,Poorly cohesive carcinoma ,Poorly Cohesive Gastric Carcinoma ,Stomach Neoplasms ,Signet ring cell carcinoma ,Internal medicine ,medicine ,Humans ,business ,Who classification ,Carcinoma, Signet Ring Cell - Abstract
Gastric cancer is one of the leading causes of cancer morbidity and mortality worldwide. It is common practice to use two classification systems: the Lauren classification system and the WHO classification of tumors in the morphological study of gastric carcinomas. Since 2010, the WHO classifications have included the term "poorly cohesive carcinoma", which refers to all diffuse forms of gastric cancer, including signet ring cell carcinoma and other subtypes. Despite this, the term has not been widely used in the world community, and it is almost not found in Russian literature. Only recently, after the publication of the 5th edition of the WHO classification (2019), there have been review articles where the term is used, but its name can be translated into Russian in different ways: poor-, weak -, low-adhesive, discogesive. The paper analyzes the Pubmed and Elibrary databases in order to find out the frequency of using various designations for diffuse gastric carcinoma, justifies the use of the term «poorly cohesive carcinoma», and proposes a variant of the term interpretation in Russian.Рак желудка — одна из ведущих причин заболеваемости и смертности от онкологических заболеваний во всем мире. При морфологическом исследовании карцином желудка принято пользоваться двумя системами классификаций — P. Lauren и опухолей ВОЗ. В классификациях ВОЗ с 2010 г. фигурирует термин «poorly cohesive carcinoma», которым обозначали все диффузные формы рака желудка, в том числе перстневидно-клеточную карциному и другие подтипы. Несмотря на это, термин не получил широкого применения в мировом сообществе и в отечественной литературе почти не встречается. Лишь в последнее время после выхода 5-го издания классификации ВОЗ (2019 г.) появляются обзорные статьи, где его используют, но название его может переводиться на русский язык по-разному: плохо-, слабо-, низкокогезивный, дискогезивный). В статье проанализированы базы данных Pubmed и eLibrary с целью выяснить частоту применения различных обозначений диффузной карциномы желудка, обосновано использование термина «poorly cohesive carcinoma» и предложен вариант трактовки термина на русском языке.
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- 2021
12. Percutaneous Radio-frequency Assisted Liver Partition with Portal vein embolization in Staged liver resection (PRALPPS) in patients with perihilar and intrahepatic cholangiocarcinoma: evaluation of short-term results
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Mikhail Efanov, Ruslan Alikhanov, A. Vankovich, O. V. Melekhina, P. Kim, Yu. V. Kulezneva, I. Kazakov, and Victor Tsvirkun
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medicine.medical_specialty ,Percutaneous ,pralpps ,RD1-811 ,business.industry ,alpps ,General Medicine ,030230 surgery ,Resection ,03 medical and health sciences ,0302 clinical medicine ,intrahepatic cholangiocarcinoma ,030220 oncology & carcinogenesis ,Portal vein embolization ,medicine ,Partition (politics) ,Surgery ,In patient ,Radiology ,business ,perihilar cholangiocarcinoma ,Intrahepatic Cholangiocarcinoma - Abstract
Objective. To estimate the short-term results of modified variant of ALPPS (PRALPPS) in patients with perihilar and intrahepatic cholangiocarcinoma.Material and methods. Procedure was indicated for future liver remnant Results. PRALPPS was applied in 13 patients and completed in 10 patients. Degree of hypertrophy and kinetic growth rate were 48 and 4.3%/day respectively. Major morbidity (>II) after the stage 1 and 2 was presented in 3 (only IIIa) and 7 patients, respectively.Conclusion. PRALPPS may be considered as an effective and safe procedure in patients with perihilar and intrahepatic cholangiocarcinoma.
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- 2019
13. Prediction of postpancreatoduodenectomy pancreatic fistula with the use of computer tomography
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S. A. Domrachev, N. S. Starostina, Victor Tsvirkun, P. Tyutyunnik, Yu. V. Kulezneva, А. V. Andrianov, K. A. Les’ko, B. S. Nikitin, Roman Izrailov, V. V. Schadrova, M. Baychorov, O. S. Vasnev, M. Mikhnevich, and Igor Khatkov
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medicine.medical_specialty ,Radiological and Ultrasound Technology ,business.industry ,Fistula ,Early detection ,medicine.disease ,Asymptomatic ,Pancreatic surgery ,medicine.anatomical_structure ,Pancreatic fistula ,medicine ,Radiology, Nuclear Medicine and imaging ,Radiology ,medicine.symptom ,Surgical treatment ,Pancreas ,business ,Grading (tumors) - Abstract
Aim. To reveal and evaluate opportunities of preoperative computer tomography (CT) for pancreatic fistula (PF) prediction after pancreatoduodenectomy. Materials and methods . In 2005 International Study Group on Pancreatic Fistula (ISGPF) developed grading criteria for PF, including asymptomatic biochemical (Grade A), that could be treated conservatively, and clinically relevant (Grade B, Grade C), with consecutive active surgical treatment. For now ISGPF definition of PF is widely accepted. We review the literature since 2005 for original articles in English describing quantitive assessment of the pancreatic parenchyma using CT with histological validation. Low sample trials (
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- 2019
14. Laparoscopic interventions in the pancreas: an 11-year experience of a specialized center
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P. Tyutyunnik, O. S. Vasnev, R. Izrailov, Victor Tsvirkun, I. E. Khatkov, M. Baychorov, M. Mikhnevich, and A. Andrianov
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Laparoscopic surgery ,medicine.medical_specialty ,medicine.medical_treatment ,pancreatic cancer ,laparoscopic distal pancreatic resection ,chronic pancreatitis ,03 medical and health sciences ,0302 clinical medicine ,pancreatic fistula ,Pancreatic cancer ,medicine ,pancreas ,laparoscopic beger procedure ,Surgical team ,business.industry ,General Medicine ,Pylorus ,medicine.disease ,Surgery ,medicine.anatomical_structure ,Pancreatic fistula ,030220 oncology & carcinogenesis ,groove pancreatitis ,Pancreatitis ,laparoscopic pancreaticoduodenal resection ,Medicine ,030211 gastroenterology & hepatology ,laparoscopic frey procedure ,business ,Pancreas ,Abdominal surgery - Abstract
Introduction:Due to anatomical and functional specifics of the pancreas, its surgery emerged somewhat later than that of other areas of abdominal surgery, i.e. in the last 25 to 30 years of the last century. Minimally invasive laparoscopic interventions on the pancreas are still used insufficiently.Aim: To evaluate an 11-year experience of various laparoscopic interventions in the pancreas accumulated by one surgical team.Materials and methods:From November 2007 to May 2018, 371 patients (153 male and 218 female) underwent various laparoscopic pancreatic procedures for cancers of the biliopancreatoduodenal zone (n = 260), benign pancreatic tumors (n = 37), and chronic pancreatitis (n = 74). We performed 245 laparoscopic pancreaticoduodenal resections, 52 laparoscopic distal resections (LDR), 35 laparoscopic Frey procedures (FP), 18 laparoscopic total duodenopancreatectomies, 8 laparoscopic longitudinal pancreaticojejunostomies (LLPJ), 8 laparoscopic cystoenterostomies (LCE), 3 enucleations, and 2 Beger procedures (BP).Results:Laparoscopic gastropancreatoduodenal resection was performed in 197 (80.4%) cases and pylorus preserving pancreatoduodenal resection in 48 (19.6%) cases. The duration of the procedures was 412 ± 101 minutes, with blood loss volume of 220 ± 152 ml, and postoperative hospital stay of 19 ± 9 days. LDR was done laparoscopically in 50 (96.2%) patients; its duration was 228 ± 74 minutes, blood loss 40 ± 50 ml, and postoperative hospital stay 8 ± 5 days. FP, LLPJ, BP, and LCE were performed laparoscopically in 53 (93%) cases. FP lasted for 436 ± 95, LLPJ for 406 ± 82, BP for 585 ± 134, and LCE for 327 ± 90 minutes. The respective volumes of blood loos were 227 ± 217 mL in FP, 150 ± 156 mL in LLPJ, 175 ± 106 mL in BP, and 60 ± 90 mL in LCE. The postoperative hospital stay lasted for 8 ± 4 days after FP, 9 ± 7 days after LLPJ, 4.5 ± 0.7 days after BP, and 10 ± 9 days after LCE.Conclusion:Laparoscopic surgery of the pancreas is associated with minimal blood loss, absence of wound infection, and more rapid patient activation and rehabilitation. Compliance with the necessary requirements to implementation of laparoscopic technologies in high-volume centers should improve surgical results.
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- 2018
15. Antegrade cholangiostomy: analysis and prevention of complications
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A. B. Musatov, Victor Tsvirkun, Mikhail Efanov, A. Yu. Ogneva, O. V. Melekhina, L. I. Kurmanseitova, Yu. V. Kulezneva, and I. V. Patrushev
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medicine.medical_specialty ,Percutaneous ,Hepatology ,business.industry ,Gastroenterology ,Suppurative cholangitis ,Anastomosis ,Jaundice ,medicine.disease ,Nonsurgical treatment ,Surgery ,03 medical and health sciences ,0302 clinical medicine ,Medicine ,Acute pancreatitis ,030211 gastroenterology & hepatology ,030212 general & internal medicine ,Drainage ,medicine.symptom ,business ,Complication - Abstract
Aim. To analyze complications of percutaneous transhepatic cholangiostomy depending on biliary obstruction level and drainage type.Material and methods. Percutaneous transhepatic biliary drainage was carried out in 974 patients with mechanical jaundice of different genesis. External drainage was predominantly performed for distal obstruction, external-internal suprapapillary – for proximal obstruction. Strictures of biliodigestive anastomosis were managed using percutaneous balloon dilatation and long-term external-internal drainage.Results. Overall morbility was 19.1%. Significant relationship between morbidity and obstruction level, drainage type and tubes quantity was detected. Drainage tube dislocation was the most common drainage-related complication both in proximal and distal obstruction. External-internal transpapillary drainage was followed by suppurative cholangitis and acute pancreatitis in 81.5% of cases. External-internal suprapapillary drainage was accompanied by acute cholangitis in 17.1% of patients and was determined by disconnection of subsegmental ducts that required additional drainage tubes placement. In most cases, complications were corrected by minimally invasive surgery and nonsurgical treatment. Overall mortality was 1.3% (0.3% in cases of distal obstruction and 1.8% in cases of proximal obstruction).Conclusion. Percutaneous transhepatic biliary drainage is a routine non-traumatic method of biliary decompression that may be successfully used irrespective to obstruction level and cause of jaundice. External-internal suprapapillary drainage is preferable for proximal biliary obstruction while external-internal transpapillary drainage should be avoided.
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- 2018
16. A randomized prospective study of the immediate outcomes of the use of a hydro-jet dissector and an ultrasonic surgical aspirator for laparoscopic liver resection
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Ruslan Alikhanov, A. Koroleva, Victor Tsvirkun, D. Salimgereeva, Dmitry Kovalenko, Mikhail Efanov, A. Vankovich, Igor Khatkov, and I. Kazakov
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medicine.medical_specialty ,Blood Loss, Surgical ,Aspirator ,Single Center ,law.invention ,Resection ,03 medical and health sciences ,0302 clinical medicine ,Randomized controlled trial ,law ,Parenchyma ,medicine ,Clinical endpoint ,Hepatectomy ,Humans ,Ultrasonics ,Prospective Studies ,Prospective cohort study ,Hepatology ,business.industry ,Dissection ,Liver Neoplasms ,Gastroenterology ,Surgery ,Liver ,030220 oncology & carcinogenesis ,030211 gastroenterology & hepatology ,Laparoscopy ,business - Abstract
Background No prospective randomized trials comparing transection techniques for the liver parenchyma transection during laparoscopic liver resection have been performed. The aim of the study was to compare the immediate outcomes of hydro-jet dissection with ultrasonic surgical aspirator in laparoscopic liver parenchyma transection in a prospective randomized single-center study. Methods Consecutive patients with liver benign and malignant tumors presenting to a single center from May 2017 to May 2020 were enrolled in the study. The primary endpoint was the intraoperative estimated blood loss. The secondary endpoints included duration of parenchymal transection, morbidity, and overall hospital stay. Results A total of 68 patients were enrolled in the study, with 34 patients in each group. There were no differences between groups in the difficulty of resection (according to IWATE criteria and IMM score) and other basic surgical parameters. No differences were found in all primary and secondary endpoints except the expenditure. The cost of equipment was significantly higher in the group of ultrasonic aspirator. Conclusion Despite the wider use of the ultrasonic aspirator in laparoscopic liver surgery, hydro-jet and ultrasonic surgical aspirators have shown similar efficacy and safety for transection of the liver parenchyma during laparoscopic resection.
- Published
- 2020
17. Early and Long-term Outcomes of Laparoscopic and Robot-assisted Liver Resections. Specialized Center’s Experience
- Author
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K. D. Grendal, Ruslan Alikhanov, D. Akhaladze, Victor Tsvirkun, E. Zamanov, A. Vankovich, Mikhail Efanov, P. Kim, and I. Kazakov
- Subjects
medicine.medical_specialty ,Hepatology ,Colorectal cancer ,business.industry ,Incidence (epidemiology) ,Gastroenterology ,Cancer ,Liver resections ,medicine.disease ,Surgery ,Early results ,Cholangiocellular carcinoma ,Internal medicine ,medicine ,Laparoscopic resection ,business - Abstract
Aim . To compare early and long-term outcomes of laparoscopic and robot-assisted liver resections with open procedures. Material and Methods. Retrospective case-control study was performed. Pseudo-randomization was used to compare homogeneous data. We have assessed survival in patients with various forms of cholangiocellular carcinoma and colorectal cancer metastases after minimally invasive liver resections. Results. For the period 2013–2017 two hundred and fifteen minimally invasive liver resections were performed including 49 robot-assisted and 166 laparoscopic ones. Malignant tumors were in 45% of cases, benign tumors – in 42%, parasitic neoplasms – in 13%. Early results of minimally invasive resections and 70 comparable open liver resections were compared. All procedures were carried out within the same period at one institution. Immediate results were significantly better after minimally invasive liver resections both before pseudo-randomization and after that. There were 60 pairs of patients after pseudo-randomization. In groups of minimally invasive and open resections blood loss was 396 (0–3400) and 853 (20–6000) ml respectively, time of surgery – 319 (85–580) and 376 (180–775) min, incidence of severe (Clavien–Dindo II and over) complications – 10% (n = 6) and 23% (n = 14), length of postoperative hospital-stay – 9 (3–90) and 12 (2–39) days, respectively. 3-year survival after mini-invasive liver resections for colorectal cancer metastases was 70%, various forms of cholangiocellular carcinoma – 40%. Conclusion. Conventional liver resections can be successfully performed in laparoscopic or robot-assisted fashion in certain patients at specialized center of surgical hepatology with sufficient experience in open and laparoscopic liver surgery.
- Published
- 2018
18. Extended Indications for Laparoscopic Parenchyma-Sparing Resection of Posterosuperior Liver Segments in Patients with Colorectal Metastases. PSM Analysis of Outcomes in Comparison with Open Hepatectomy
- Author
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Ruslan Alikhanov, Granov Da, D. Kovalenko, Victor Tsvirkun, Mikhail Efanov, A. Vankovich, I. Kazakov, Rutkin Io, and A. Koroleva
- Subjects
medicine.medical_specialty ,Hepatology ,business.industry ,medicine.medical_treatment ,Parenchyma ,Gastroenterology ,medicine ,In patient ,Hepatectomy ,business ,Resection ,Surgery - Published
- 2021
19. Laparoscopic Frey Procedure - Multicenter Prospective Randomized Trial
- Author
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K. Nikolskaia, S. Tarasenko, K. Dalgatov, E. Diubcova, T. Dyujeva, V. Egorov, R. Izrailov, Victor Tsvirkun, and A. Andrianov
- Subjects
medicine.medical_specialty ,Hepatology ,Randomized controlled trial ,business.industry ,law ,Gastroenterology ,Medicine ,business ,Surgery ,law.invention - Published
- 2021
20. Comparison of Immediate and Long-term Outcomes after Laparoscopic and Open Radical Surgery for Hydatid Liver Cysts
- Author
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K. Kurbonov, A. Vankovich, N. Elizarova, Ruslan Alikhanov, A. Koroleva, I. Kazakov, Z. Azizzoda, Victor Tsvirkun, and Mikhail Efanov
- Subjects
medicine.medical_specialty ,Hepatology ,business.industry ,Gastroenterology ,Long term outcomes ,Medicine ,Radical surgery ,business ,Liver cysts ,Surgery - Published
- 2021
21. 358 total laparoscopic pancreatoduodenectomy for patients with lesions of the head of the pancreas and periampullary area
- Author
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P. Tyutyunnik, P. Agami, O. Vasnev, M. Mikhnevich, A. Andrianov, D. Salimgereeva, R. Izrailov, Victor Tsvirkun, Igor Khatkov, and M. Baychorov
- Subjects
medicine.medical_specialty ,medicine.anatomical_structure ,Hepatology ,business.industry ,Gastroenterology ,Medicine ,Head (vessel) ,Radiology ,business ,Pancreas - Published
- 2021
22. Laparoscopic and robotic radical surgery for liver alveolar echinococcosis
- Author
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Victor Tsvirkun, Natalia Elizarova, Mikhail Efanov, Ruslan Alikhanov, O. V. Melekhina, A. Vankovich, I. Kazakov, and Yulia Kulezneva
- Subjects
Radical treatment ,medicine.medical_specialty ,business.industry ,Alveolar echinococcosis ,Liver resections ,medicine.disease ,Echinococcosis ,Surgery ,Lesion ,Medicine ,General Materials Science ,In patient ,Radical surgery ,medicine.symptom ,Stage (cooking) ,business - Abstract
Introduction The aim of this study was to estimate the immediate and long-term results of laparoscopic and robotic radical surgery for liver alveolar echinococcosis (AE). Methods From 2013 to 2019 6 patients with AE were undergone radically surgery using minimally invasive technologies. In 5 cases, a laparoscopic liver resection was performed, and in one case a Da'Vinci robotic complex was used. The average lesion size was 60 ± 20 mm. Results In three cases (50%) patients with P2 stage of the disease were operated on, in 3 cases with P1. In two cases, in patients with stage P2, a right hemihepatectomy was performed, in 2 cases a segmentectomy 8 with atypical resection segment 4 was performed, in one case a posterior sectionectomy was performed, in one case the intervention was performed with atypical resection of 6 segments. The average age of the patients was 55 years (27-79), three women and three men (1:1). The average size of the lesion was 60 ± 20 cm. The mean operation time and blood loss was 344 ± 141 minutes and 350 ± 333 mL. Complications were observed in one case (16.7%), type II according to Clavien-Dindo, represented by dynamic intestinal obstruction, which developed on the 6th day of the postoperative period and was resolved conservatively. Mean hospital stay was 9 ± 3. Conclusions Laparoscopic and robotic liver resections in the radical treatment of alveococcosis can be safe and feasible in the early stages of alveococcosis (P1-2H0M0), provided they are performed in a specialized hospital with sufficient technical equipment and an experienced surgeon.
- Published
- 2021
23. Laparoscopic radical and conservative surgery of hydatid liver echinococcosis. PSM based comparative analysis of immediate and long-term outcomes
- Author
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Mikhail Efanov, Natalia Elizarova, Yulia Kulezneva, O. V. Melekhina, Victor Tsvirkun, and Ruslan Alikhanov
- Subjects
Laparoscopic surgery ,medicine.medical_specialty ,Laparoscopic cystectomy ,business.industry ,medicine.medical_treatment ,Retrospective cohort study ,medicine.disease ,Echinococcosis ,Surgery ,Cystectomy ,medicine ,Long term outcomes ,Severe morbidity ,General Materials Science ,Radical surgery ,business - Abstract
Introduction The diffusion of laparoscopic radical surgery of hydatid liver echinococcosis remains limited. There no published data on a comparative analysis of the immediate and long-term results of radical and conservative laparoscopic surgery for liver hydatid cysts. Comparison of the immediate and long-term outcomes after laparoscopic radical and conservative cystectomies was aimed. Methods HPB center (center 1) and general surgery hospital in endemic area (center 2) participated in retrospective study. Radical surgery included total, subtotal pericystectomy and liver resection. Conservative surgery comprised cystectomy without/with partial pericystectomy. Results The total number of patients was 204. Laparoscopic cystectomy was performed in 97 (47%) patients. Radical (n-40) and conservative (n-61) laparoscopic procedures were performed in center 1 and center 2, respectively. Twenty-five pairs of patients were matched. The length of hospital stay and time of abdominal drainage were significantly shorter after radical surgery before and after PSM. The rate of severe morbidity did not differ. The mean follow-up length was 34 and 45 months in center 1 and center 2, respectively. No differences were found in the disease recurrence rate. Conclusions Laparoscopic radical surgery leads to a reduction in the treatment time and can be recommended as the preferred treatment option in a specialized HPB center.
- Published
- 2021
24. The Russian consensus on the diagnosis and treatment of chronic pancreatitis: Enzyme replacement therapy
- Author
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Dmitry S. Bordin, E A Kornienko, E. V. Bystrovskaya, N Yu Kokhanenko, N.I. Ursova, T G Dyuzheva, Igor Khatkov, V. D. Pasechnikov, Igor G. Bakulin, Maria A. Livzan, Emilia Galperin, N. V. Korochanskaya, E V Beloborodova, E.I. Alieva, A. V. Okhlobystin, S I Polyakova, V L Korobka, Sayar Abdulkhakov, S V Vertyankin, Oleg A. Sablin, M F Osipenko, I D Loranskaya, Yu A Kucheryavyi, E. A. Belousova, A Yu Baranovsky, V V Tsukanov, V E Zagainov, Mikhail Efanov, Roman Izrailov, A.V. Gorelov, E Yu Plotnikova, V I Egorov, E.A. Dubtsova, V I Simanenkov, Zakharova Nv, R B Alikhanov, K.A. Nikolskaya, Victor Tsvirkun, Vladimir Ivashkin, A V Shabunin, Grinevich Vb, S A Alekseenko, V V Darvin, M V Danilov, L V Vinokurova, I M Buriev, and Igor V. Maev
- Subjects
History ,Pathology ,medicine.medical_specialty ,Consensus ,diagnosis ,Endocrinology, Diabetes and Metabolism ,lcsh:Medicine ,Moscow ,chronic pancreatitis ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Pancreatitis, Chronic ,Diagnosis ,medicine ,Humans ,treatment ,business.industry ,lcsh:R ,virus diseases ,Disease Management ,General Medicine ,Enzyme replacement therapy ,medicine.disease ,Treatment ,030220 oncology & carcinogenesis ,Pancreatitis ,030211 gastroenterology & hepatology ,russian consensus ,Family Practice ,business ,Chronic pancreatitis ,geographic locations ,enzyme replacement therapy - Abstract
Pancreatology Club Professional Medical Community, 1A.S. Loginov Moscow Clinical Research and Practical Center, Moscow Healthcare Department, Moscow; 2A.I. Evdokimov Moscow State University of Medicine and Dentistry, Ministry of Health of Russia, Moscow; 3Kazan State Medical University, Ministry of Health of Russia, Kazan; 4Kazan (Volga) Federal University, Kazan; 5Far Eastern State Medical University, Ministry of Health of Russia, Khabarovsk; 6Morozov City Children's Clinical Hospital, Moscow Healthcare Department, Moscow; 7I.I. Mechnikov North-Western State Medical University, Ministry of Health of Russia, Saint Petersburg; 8Siberian State Medical University, Ministry of Health of Russia, Tomsk; 9M.F. Vladimirsky Moscow Regional Research Clinical Institute, Moscow; 10Maimonides State Classical Academy, Moscow; 11V.I. Razumovsky State Medical University, Ministry of Health of Russia, Saratov; 12I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia, Moscow; 13S.M. Kirov Military Medical Academy, Ministry of Defense of Russia, Saint Petersburg; 14Surgut State Medical University, Ministry of Health of Russia, Surgut; 15City Clinical Hospital Five, Moscow Healthcare Department, Moscow; 16Nizhny Novgorod Medical Academy, Ministry of Health of Russia, Nizhny Novgorod; 17Territorial Clinical Hospital Two, Ministry of Health of the Krasnodar Territory, Krasnodar; 18Saint Petersburg State Pediatric Medical University, Ministry of Health of Russia, Saint Petersburg; 19Rostov State Medical University, Ministry of Health of Russia, Rostov-on-Don; 20Omsk Medical University, Ministry of Health of Russia, Omsk; 21Russian Medical Academy of Postgraduate Education, Ministry of Health of Russia, Moscow; 22Novosibirsk State Medical University, Ministry of Health of Russia, Novosibirsk; 23Stavropol State Medical University, Ministry of Health of Russia, Stavropol; 24Kemerovo State Medical University, Ministry of Health of Russia, Kemerovo; 25N.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia, Moscow; 26A.M. Nikiforov All-Russian Center of Emergency and Radiation Medicine, Russian Ministry for Civil Defense, Emergencies and Elimination of Consequences of Natural Disasters, Saint Petersburg; 27Research Institute for Medical Problems of the North, Siberian Branch, Russian Academy of Sciences, Krasnoyarsk; 28S.P. Botkin City Clinical Hospital, Moscow Healthcare Department, Moscow; 29Tver State Medical University, Ministry of Health of Russia, Tver The Russian consensus on the diagnosis and treatment of chronic pancreatitis has been prepared on the initiative of the Russian Pancreatology Club to clarify and consolidate the opinions of Russian specialists (gastroenterologists, surgeons, and pediatricians) on the most significant problems of diagnosis and treatment of chronic pancreatitis. This article continues a series of publications explaining the most significant interdisciplinary consensus statements and deals with enzyme replacement therapy.Российский консенсус по диагностике и лечению хронического панкреатита подготовлен по инициативе Российского 'Панкреатологического клуба' с целью выяснения и консолидации мнений отечественных специалистов (гастроэнтерологов, хирургов и педиатров) по наиболее важным проблемам диагностики и лечения хронического панкреатита. Настоящая статья продолжает серию публикаций, разъясняющих наиболее важные положения междисциплинарного консенсуса и посвящена вопросам заместительной ферментной терапии.
- Published
- 2017
25. HEPATOBILIARY SCINTIGRAPHY FOR RISK ASSESSMENT OF POSTHEPATECTOMY LIVER FAILURE
- Author
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S. G. Khomeriki, B. S. Nikitin, L. V. Bondar, Yu. V. Kulezneva, N. S. Starostina, O. V. Melekhina, Mikhail Efanov, Victor Tsvirkun, P. Kim, E. V. Vinnitskaya, and Ruslan Alikhanov
- Subjects
Hepatitis ,medicine.medical_specialty ,Percutaneous ,Cirrhosis ,Hepatology ,medicine.diagnostic_test ,business.industry ,Radiofrequency ablation ,medicine.medical_treatment ,Gastroenterology ,medicine.disease ,Scintigraphy ,Liver regeneration ,law.invention ,law ,Internal medicine ,medicine ,Surgery ,Embolization ,Liver cancer ,business - Abstract
Aim: to assess the role of hepatobiliary scintigraphy for prognosis of hepatic failure after liver resection; to determine threshold index of hepatic uptake of radioactive agent as an indication for surgical prevention of hepatic failure. Material and Methods. The study included 2 groups of patients who underwent hepatobiliary scintigraphy. The 1st group consisted of 50 patients with diffuse liver diseases (chronic hepatitis, liver cirrhosis) in whom histological examination of liver was performed according to METAVIR. 49 patients with liver tumors underwent advanced liver resections (over segments by Couinaud). Results. The highest median of hepatic uptake (2,86) was revealed in patients with liver fibrosis F1, the lowest (2,02) – in patients with liver fibrosis F4. Threshold value of hepatic uptake was 2,4. In 18 patients with hepatic uptake index
- Published
- 2017
26. Perihilar cholangiocarcinoma with and without portal vein and hepatic artery resection: Comparative analysis of early and late outcomes
- Author
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A. Vankovich, P. Kim, I. Kazakov, Victor Tsvirkun, E. Zamanov, Mikhail Efanov, Ruslan Alikhanov, and S. Sarkisyan
- Subjects
medicine.medical_specialty ,medicine.anatomical_structure ,Hepatology ,business.industry ,Gastroenterology ,Portal vein ,medicine ,Radiology ,Perihilar Cholangiocarcinoma ,business ,Resection ,Artery - Published
- 2020
27. [Early outcomes of robot-assisted liver resection]
- Author
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Victor Tsvirkun, I. Kazakov, K. D. Grendal, Ruslan Alikhanov, M. Yu. Prostov, A. Vankovich, P. Kim, and Mikhail Efanov
- Subjects
medicine.medical_specialty ,business.industry ,Liver Diseases ,Operative Time ,Blood Loss, Surgical ,General Medicine ,030230 surgery ,Liver resections ,Surgery ,Resection ,03 medical and health sciences ,0302 clinical medicine ,Treatment Outcome ,Blood loss ,Liver ,Robotic Surgical Procedures ,030220 oncology & carcinogenesis ,medicine ,Hepatectomy ,Humans ,Morbidity ,business ,Retrospective Studies - Abstract
To assess an experience of robot-assisted liver resection using CUSUM-test.The results of 46 robot-assisted liver resections were retrospectively analyzed by using of CUSUM-test.There were 3 periods in development of the technology. The 1В последнее десятилетие набирает популярность оценка кривых обучения при помощи метода статистического анализа CUSUM (cumulative sum). Цель исследования - оценить опыт освоения робот-ассистированных резекций печени при помощи метода CUSUM. Материал и методы. При помощи метода CUSUM проведен ретроспективный анализ результатов 46 робот-ассистированных резекций печени. Результаты. Выделены 3 периода в освоении технологии: 1-й - обучение операциям с низким индексом сложности (n=16), 2-й - расширение показаний к операциям с высоким уровнем сложности (n=18) и 3-й - стабилизация показателей (n=12). Изучена динамика индекса сложности резекций печени, объема интраоперационной кровопотери, длительности операции и частоты осложнений II-V класса по Clavien-Dindo. Согласно данным анализа, снижение показателей кровопотери и длительности резекции печени произошло после 5-й операции. Переход к сложным резекциям печени потребовал выполнения 16 операций. Стабилизация периоперационных параметров наступила после 34 резекций печени. Заключение. Технология CUSUM представляется эффективным методом оценки кривой обучения робот-ассистированным резекциям печени.
- Published
- 2018
28. Laparoscopic and robotic radical surgery for liver alveolar echinococcosis (Echinococcus multilocularis)
- Author
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Mikhail Efanov, N. Elizarova, O. V. Melekhina, Victor Tsvirkun, Y. Kulezneva, and Ruslan Alikhanov
- Subjects
Pathology ,medicine.medical_specialty ,Hepatology ,biology ,business.industry ,Gastroenterology ,Medicine ,Alveolar echinococcosis ,Radical surgery ,business ,Echinococcus multilocularis ,biology.organism_classification - Published
- 2021
29. Pancreatic Stump Reinforcement with Falciform Ligament during Laparoscopic Distal Pancreatectomy
- Author
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P. Tyutyunnik, M. Bayorov, P. Agami, Igor Khatkov, A. Andrianov, Victor Tsvirkun, R. Izrailov, D. Salimgereeva, O. Vasnev, and M. Mikhnevich
- Subjects
medicine.medical_specialty ,medicine.anatomical_structure ,Hepatology ,business.industry ,Gastroenterology ,medicine ,Falciform ligament ,Distal pancreatectomy ,business ,Pancreatic stump ,Surgery - Published
- 2021
30. Pancreatic fistula prediction scale for laparoscopic pancreatoduodenectomy
- Author
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A. Andrianov, P. Tyutyunnik, Igor Khatkov, R. Izrailov, O. Vasnev, M. Mikhnevich, P. Agami, M. Baychorov, and Victor Tsvirkun
- Subjects
medicine.medical_specialty ,Hepatology ,Scale (ratio) ,business.industry ,Pancreatic fistula ,Gastroenterology ,medicine ,Radiology ,business ,medicine.disease - Published
- 2021
31. Single center experience of thirty five consecutive total duodenopancreatectomies
- Author
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P. Tytyunnik, R. Izrailov, P. Agami, Igor Khatkov, M. Baychorov, Victor Tsvirkun, M. Mikhnevich, and A. Andrianov
- Subjects
medicine.medical_specialty ,Hepatology ,business.industry ,General surgery ,Gastroenterology ,medicine ,Single Center ,business - Published
- 2021
32. Laparoscopic Radical Surgery for Hydatid Liver Cysts. PSM Based Analysis of Outcomes in Comparison with Conservative Laparoscopic Cystectomy
- Author
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I. Kazakov, Z. Azizzoda, Ruslan Alikhanov, A. Koroleva, A. Vankovich, Victor Tsvirkun, Mikhail Efanov, N. Elizarova, and K. Kurbonov
- Subjects
medicine.medical_specialty ,Laparoscopic cystectomy ,Hepatology ,business.industry ,Gastroenterology ,medicine ,Radical surgery ,business ,Liver cysts ,Surgery - Published
- 2021
33. Immediate outcomes of robotic resection for hilar cholangiocarcinoma. Initial experience evaluation
- Author
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O. V. Melekhina, Victor Tsvirkun, Mikhail Efanov, I. Kazakov, Ruslan Alikhanov, P. Kim, A. Koroleva, E. Zamanov, and A. Vankovich
- Subjects
medicine.medical_specialty ,Hepatology ,business.industry ,Gastroenterology ,Medicine ,business ,Resection ,Surgery - Published
- 2020
34. Long-term survival after radical treatment for perihilar cholangiocarcinoma
- Author
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P. Kim, I. Kazakov, Mikhail Efanov, A. Vankovich, O. V. Melekhina, A. Koroleva, Victor Tsvirkun, Ruslan Alikhanov, E. Zamanov, and Y. Kulezneva
- Subjects
Radical treatment ,medicine.medical_specialty ,Hepatology ,business.industry ,Internal medicine ,Long term survival ,Gastroenterology ,medicine ,Perihilar Cholangiocarcinoma ,business - Published
- 2020
35. [Intrahepatic cholangiocarcinoma followed by vascular invasion: is surgical treatment justified?]
- Author
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O. V. Melekhina, P. Kim, A. Vankovich, Ruslan Alikhanov, Mikhail Efanov, Yu. V. Kulezneva, Victor Tsvirkun, D. Akhaladze, and I. Kazakov
- Subjects
Male ,medicine.medical_specialty ,Vena Cava, Inferior ,030230 surgery ,Inferior vena cava ,Vascular invasion ,Russia ,Cholangiocarcinoma ,03 medical and health sciences ,Blood Vessel Prosthesis Implantation ,0302 clinical medicine ,Postoperative Complications ,medicine ,Hepatectomy ,Humans ,Neoplasm Invasiveness ,Venous bypass ,Radical surgery ,Surgical treatment ,Intrahepatic Cholangiocarcinoma ,Aged ,Neoplasm Staging ,business.industry ,Portal Vein ,Portal Vein Bifurcation ,General Medicine ,Middle Aged ,Surgery ,Treatment Outcome ,Great vessels ,medicine.vein ,Bile Duct Neoplasms ,030220 oncology & carcinogenesis ,cardiovascular system ,Female ,business - Abstract
Intrahepatic cholangiocarcinoma (ICC) is one of the most aggressive tumors associated with poor prognosis. Radical surgery is still the main method of treatment in resectable cases. Certain difficulties are observed in case of locally advanced tumors followed by inferior vena cava (IVC) and portal vein (PV) invasion.To analyze safety of advanced liver resections combined with great vessels repair for locally advanced large and multiple cholangiocellular carcinoma.Since January 2014 till April 2017 eighty ICC patients have undergone advanced liver resection. There were 62 patients with portal cholangiocarcinoma and 18 with ICC. 4 ICC patients required vascular repair: IVC replacement in 2 cases (i.e. under venous bypass in 1 of them), tangential and circular resection of portal vein bifurcation - in 2 cases.Postoperative complications Clavien-Dindo IIIa developed in all cases. There were no vascular complications. The length of hospital-stay was 14 - 35 days. There were no lethal outcomes. Annual survival was 50%, 2-year - 25%. Adjuvant chemotherapy was used in all patients.Advanced liver resection followed by IVC and PV repair for locally advanced ICC may be safely performed and subsequently allows chemotherapeutic treatment.Внутрипеченочная холангиокарцинома (ВХК) ― одна из наиболее агрессивных опухолей, ассоциированных с плохим прогнозом. Основным методом лечения в резектабельных случаях остается радикальная хирургическая операция. Наиболее трудновыполнимой она становится при местно-распространенных формах поражения, особенно при вовлечении нижней полой вены (НПВ) и воротной вены (ВВ). Цель исследования ― проанализировать безопасность выполнения обширных резекций печени, комбинированных с резекцией и реконструкцией магистральных сосудов при местно-распространенных больших и множественных поражениях холангиоцеллюлярным раком внутрипеченочной локализации. Материал и методы. С января 2014 г. по апрель 2017 г. 80 пациентам с холангиокарциномой выполнены обширные резекции печени. Среди них ― 62 были радикально оперированы по поводу воротной холангиокарциномы и 18 с ВХК. Резекция и реконструкция сосудов потребовались 4 пациентам с ВХК: в 2 случаях ― протезирование НПВ (из них 1 пациенту ― в условиях обходного вено-венозного шунтирования), в 2 случаях ― краевая и циркулярная резекции бифуркации воротной вены. Результаты. Послеоперационные осложнения класса IIIа по классификации Clavien―Dindo развились во всех 4 случаях. Сосудистые осложнения отсутствовали. Продолжительность пребывания в стационаре колебалась от 14 до 35 дней. Летальных исходов не было. Годичная выживаемость составила 50%. 25% пациентов пережили двухлетний рубеж. Все пациенты получали адъювантную химиотерапию. Вывод. Обширные резекции печени, комбинированные с резекцией НПВ и ВВ при местно-распространенной ВХК, могут быть выполнены безопасно для пациентов и в последующем позволяют провести химиотерапевтическое лечение.
- Published
- 2018
36. Comparison of RALLPS, portal vein embolisation(PVE) and portal vein ligation(PVL) in prevention of posthepatectomy liver failure
- Author
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Victor Tsvirkun, N. S. Starostina, A. Vankovich, I. Kazakov, Mikhail Efanov, Ruslan Alikhanov, O. V. Melekhina, P. Kim, and J.V. Kulezneva
- Subjects
medicine.medical_specialty ,Hepatology ,business.industry ,Gastroenterology ,Portal vein ,Liver failure ,Medicine ,Portal vein ligation ,business ,Surgery - Published
- 2019
37. Comparative analysis of learning curve in complex robot-assisted and laparoscopic liver resection
- Author
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P. Kim, I. Kazakov, Victor Tsvirkun, O. V. Melekhina, Igor Khatkov, Mikhail Efanov, Konstantin Grendal, Stanislav Berelavichus, Ruslan Alikhanov, and A. Vankovich
- Subjects
Liver surgery ,Adult ,Male ,medicine.medical_specialty ,Time Factors ,Adolescent ,Treatment outcome ,030230 surgery ,Liver resections ,Resection ,03 medical and health sciences ,Young Adult ,0302 clinical medicine ,Postoperative Complications ,Robotic Surgical Procedures ,medicine ,Hepatectomy ,Humans ,Aged ,Retrospective Studies ,Hepatology ,business.industry ,Gastroenterology ,Retrospective cohort study ,Middle Aged ,Surgery ,Index score ,Treatment Outcome ,Learning curve ,030220 oncology & carcinogenesis ,Female ,Laparoscopy ,Clinical Competence ,Clinical competence ,business ,Learning Curve - Abstract
Background There is no comparative analysis of the learning curves for robot-assisted and laparoscopic liver resection. We aimed to compare learning curves in complex robotic and conventional laparoscopic liver resections with regards to estimation of the difficulty index score. Methods The results of 131 consecutive liver resections were analyzed retrospectively (40 robot-assisted and 91 laparoscopic). The learning curve evaluation was based on calculation of procedures number before significant change of the difficulty index for minimally invasive liver resection or the rate of posterosuperior segments resection. Groups of early and late experience were compared in every type of approach (robot-assisted and laparoscopic). Results Significant increase of difficulty index (from 5.0 [3.0–7.7] to 7.3 [4.3–10.2]) of robotic procedures required 16 procedures. It was necessary to perform 29 laparoscopic resections in order to significantly increase the rate of laparoscopic posterosuperior segments resection but without significant increase of difficulty index. The implementation of minimally invasive liver resection started with the robotic approach. Conclusion The learning curve for robot-assisted liver resections is shorter in comparison with laparoscopic resections. The inclusion of robot-assisted resections in a minimally invasive liver surgery program may be useful to rapidly increase the complexity of laparoscopic liver resections.
- Published
- 2017
38. Short-term results of minimally invasive liver resection for benign tumors. single center experience
- Author
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K. Grendal, N. Elizarova, P. Kim, Mikhail Efanov, I. Kazakov, Victor Tsvirkun, Ruslan Alikhanov, E. Zamanov, and A. Vankovich
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medicine.medical_specialty ,Hepatology ,business.industry ,Gastroenterology ,Medicine ,Single Center ,business ,Resection ,Surgery ,Term (time) - Published
- 2018
39. The single center early experience in robot-assisted pancreatoduodenectomy
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N. Elizarova, Ruslan Alikhanov, P. Kim, A. Vankovich, Victor Tsvirkun, Mikhail Efanov, and I. Kazakov
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Hepatology ,business.industry ,Gastroenterology ,Medicine ,Robot ,Computer vision ,Artificial intelligence ,business ,Single Center - Published
- 2018
40. Vascular resection for hilar cholangiocarcinoma. Analysis of technical challenges
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A. Vankovich, S. Iskhagi, Mikhail Efanov, I. Kazakov, Ruslan Alikhanov, E. Zamanov, D. Akhaladze, P. Kim, and Victor Tsvirkun
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medicine.medical_specialty ,Hepatology ,business.industry ,Gastroenterology ,Medicine ,Radiology ,Vascular resection ,business - Published
- 2018
41. Eras protocol for laparoscopic Frey procedure
- Author
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A. V. Andrianov, Victor Tsvirkun, Ruslan Alikhanov, and R. E. Izrailov
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Protocol (science) ,medicine.medical_specialty ,medicine.diagnostic_test ,business.industry ,General Medicine ,Surgery ,03 medical and health sciences ,0302 clinical medicine ,Blood loss ,030220 oncology & carcinogenesis ,Operating time ,Medicine ,030211 gastroenterology & hepatology ,Fast track ,business ,Laparoscopy - Abstract
Aim To assess the use of ERAS in laparoscopic Frey procedure. Material and methods From August 2012 to November 2017 laparoscopic Frey procedure were performed in 35 patients. Fully laparoscopic were performed 31 (88.5%) procedures. We use fast-track protocol from 13 patients. We included from statistic analyses patients where procedure was changed or was conversion or was simultaneous procedure. The total number of patients analyzed was 27. The patients were divided into two groups: I - before the fast-track protocol (n=11), II - after the protocol implementation (n=16). Results The operating time was 460 (365-530) minutes in I group and 420 (295-540) minutes in II group. Blood loss was 150 (5-300) and 150 (40-700) ml. The median postoperative stay period was 10 (5-25) days and 6.5 (3-11) days (p=0.007). Conclusion The combination of laparoscopic technologies and fast-track protocol reduces the duration of the postoperative stay period.
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- 2019
42. Hepatobiliary scintigraphy for risk assessment of posthepatctomy liver failure
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L. V. Bondar, Mikhail Efanov, N. S. Starostina, O. V. Melekhina, Ruslan Alikhanov, B. S. Nikitin, V. Kulezneva Yu, E.V. Vinnickaya, P. Kim, Victor Tsvirkun, and S. G. Khomeriki
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medicine.medical_specialty ,Hepatology ,medicine.diagnostic_test ,business.industry ,Gastroenterology ,medicine ,Liver failure ,Radiology ,Scintigraphy ,Risk assessment ,business - Published
- 2019
43. Laparoscopic vascular reconstruction among 114 total laparoscopic pancreatoduodenectomies
- Author
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A.A. Khisamov, A. Andrianov, R. Izrailov, Igor Khatkov, Victor Tsvirkun, and P.S. Tyutyunnik
- Subjects
medicine.medical_specialty ,Hepatology ,business.industry ,Vascular reconstruction ,medicine ,Gastroenterology ,business ,Surgery - Published
- 2016
- Full Text
- View/download PDF
44. Laparoscopic frey procedure
- Author
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Victor Tsvirkun, R. Izrailov, A. Andrianov, and Ruslan Alikhanov
- Subjects
medicine.medical_specialty ,Hepatology ,business.industry ,medicine ,Gastroenterology ,business ,Surgery - Published
- 2016
- Full Text
- View/download PDF
45. Hepatobiliary scintigraphy assessment of liver function after portal vein embolization and RALPPS
- Author
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S. Iskhagi, I. Kazakov, L. V. Bondar, Y. Kulezneva, Ruslan Alikhanov, O. V. Melekhina, D. Akhaladze, Victor Tsvirkun, P. Kim, Mikhail Efanov, and A. Vankovich
- Subjects
medicine.medical_specialty ,Hepatology ,medicine.diagnostic_test ,business.industry ,Portal vein embolization ,Gastroenterology ,medicine ,Radiology ,Liver function ,Scintigraphy ,business - Published
- 2018
46. Radio-frequency assisted liver partition with portal vein embolization in staged liver resection (RALPPS) in patients with hilar and intrahepatic cholangiocarcinoma
- Author
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P. Kim, Ruslan Alikhanov, I. Kazakov, Mikhail Efanov, Victor Tsvirkun, O. V. Melekhina, N. Kulikova, E. Zamanov, A. Vankovich, and Y. Kulezneva
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medicine.medical_specialty ,Hepatology ,business.industry ,Portal vein embolization ,Gastroenterology ,Partition (politics) ,medicine ,In patient ,Radiology ,business ,Intrahepatic Cholangiocarcinoma ,Resection - Published
- 2018
47. Comparetive analysis of laparoscopic-assisted and open liver resection for large hepatic tumors
- Author
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A. Vankovich, I. Kazakov, Victor Tsvirkun, S. Iskhagi, Ruslan Alikhanov, D. Akhaladze, P. Kim, Mikhail Efanov, E. Zamanov, and K. Grendal
- Subjects
medicine.medical_specialty ,Open liver resection ,Hepatology ,business.industry ,Gastroenterology ,medicine ,business ,Surgery - Published
- 2018
48. Comparison of CT and hepatobiliary scintigraphy in volumetry of future liver remnant after portal vein embolization and RALPPS
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O. V. Melekhina, Victor Tsvirkun, P. Kim, Ruslan Alikhanov, Mikhail Efanov, L. V. Bondar, S. Iskhagi, Y. Kulezneva, I. Kazakov, and A. Vankovich
- Subjects
medicine.medical_specialty ,Hepatology ,medicine.diagnostic_test ,business.industry ,Portal vein embolization ,Gastroenterology ,medicine ,Radiology ,Scintigraphy ,business - Published
- 2018
49. Minimally Invasive versus open hepatectomy for colorectal cancer liver metastases: comparative analysis of short-term results and survival with propensity score matching
- Author
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P. Kim, Mikhail Efanov, A. Vankovich, E. Zamanov, K. Grendal, Victor Tsvirkun, I. Kazakov, and Ruslan Alikhanov
- Subjects
Oncology ,medicine.medical_specialty ,Hepatology ,Colorectal cancer ,business.industry ,medicine.medical_treatment ,Gastroenterology ,medicine.disease ,Term (time) ,Internal medicine ,Propensity score matching ,medicine ,Hepatectomy ,business - Published
- 2018
50. Laparoscopic pancreatic head resection
- Author
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Victor Tsvirkun, Ruslan Alikhanov, R. E. Izrailov, and A. V. Andrianov
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Adult ,Male ,Pancreatic duct ,medicine.medical_specialty ,business.industry ,Recurrent pain ,General Medicine ,Middle Aged ,medicine.disease ,Pancreatic head ,Resection ,Surgery ,Outcome and Process Assessment, Health Care ,Pancreatectomy ,Postoperative Complications ,medicine.anatomical_structure ,Blood loss ,Pancreatitis, Chronic ,medicine ,Humans ,Pancreatitis ,Female ,Laparoscopy ,business ,Pancreas - Abstract
To analyze the features and efficacy of laparoscopic Frey procedure.For the period from August 2012 to May 2017 Frey procedure was carried out in 31 patients with chronic calculous pancreatitis Buchler type C. There were 20 men and 11 women aged 48.6±9 years. Mean pancreatic head dimension was 35.5±14 mm, diameter of the main pancreatic duct - 9.6±2.7 mm.Completely laparoscopic procedure was made in 28 (90.3%) cases. One patient required intraoperatively Beger's technique without conversion. The last was need in 2 (6.5%) cases. Time of surgery and blood loss were 447.3±90.4 min and 215±177.7 ml respectively. Mean postoperative hospital-stay was 8.4±4.5 days. Postoperative complications occurred in 7 patients. Mortality was absent. Follow-up was 1-41 months. Recurrent pain syndrome was observed in 1 case. However, it was less severe and does not require analgesia.Цель исследования - изучение особенностей и оценка эффективности выполнения операции Фрея лапароскопическим способом. Материал и методы. В МКНЦ с августа 2012 г. по май 2017 г. выполнена 31 операция Фрея у пациентов с хроническим калькулезным панкреатитом типа С по M. Buchler. Среди больных было 20 мужчин и 11 женщин. Возраст пациентов составил 48,6±9 лет. Средний размер головки поджелудочной железы 35,5±14 мм, диаметр главного панкреатического протока 9,6±2,7 мм. Результаты. В 28 (90,3%) наблюдениях операции были выполнены в намеченном объеме полностью лапароскопическим способом. У одного пациента объем операции был расширен до операции Бегера без конверсии. В 2 (6,5%) наблюдениях потребовалась конверсия доступа. Продолжительность операций составила 447,3±90,4 мин, объем кровопотери - 215±177,7 мл. Средняя продолжительность послеоперационного периода 8,4±4,5 койко-дня. У 7 пациентов в послеоперационном периоде возникли осложнения. Случаев летального исхода не было. Продолжительность наблюдения за пациентами составляет от 1 до 41 мес. Рецидив болевого синдрома отмечен у одного пациента, однако меньшей интенсивности и не требующий приема обезболивающих препаратов.
- Published
- 2018
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