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Management of patients with various diseases of the pancreas after drainage and resection operations

Relevance. Pathophysiological changes after pancreatic resection are reduced to changes in the physiology of the stomach: violation of fundal relaxation due to the disappearance of antrofundal and duodenofundal reflux, violation of nervous stimulation of pancreatic secretion due to the absence of fundal relaxation. Changes in the physiology of the duodenum (duodenum): reduced cholecystokinin stimulation of pancreatic secretion, secondary changes due to resection of the duodenum. Changes in the physiology of the pancreas: resection of the pancreas and its underlying disease leads to a decrease in secretion, as well as disorders associated with changes in the relationship with the stomach and the duodenum.
Total or partial resection of the pancreas is certainly a risk factor for the development of its functional insufficiency. There is a close relationship between the exo - and endocrine functions of the pancreas. Thus, trypsin affects the synthesis of insulin and glucagon. The external secretion is affected by the level of blood glucose and insulin: it provides the supply of amino acids and glucose to the acinuses.
70% of patients who have undergone subtotal resection of the pancreas develop type 3 diabetes mellitus.As part of the program, we:    

  1. We will discuss the severity of exocrine insufficiency depending on the type of surgical intervention on the pancreas.
  2. We will study the features of the course, diagnosis, and treatment of diabetes mellitus caused by diseases of the pancreas.
  3. We will work out an algorithm for managing patients with total pancreatectomy.
  4. Consider the features of nutritional support after resection operations on the pancreas.
  5. During the training, recommendations for the diagnosis and treatment of patients who have undergone surgical interventions on the pancreas will be presented.

Base: department of Pathology of the pancreas and Bile ducts of the State Medical Institution MCSC named after A. S. Loginov DZM
Internship Supervisors: Bordin D. S., MD, Professor, Head of the Department of Pathology of the pancreas, bile ducts and Upper Digestive Tract of the State Medical Institution of the MCSC named after A. S. Loginov DZM, chief freelance gastroenterologist of the Department of Health of Moscow.
Dubtsova E. A., MD, Head of the Department of Pathology of the pancreas and Bile Ducts of the State Medical Institution of the MCSC named after A. S. Loginov DZM.
Vinokurova L. V., MD, Senior researcher of the Department of Pathology of the Pancreas and Bile Ducts of the State Medical Institution of the MCSC named after A. S. Loginov DZM.
Nikolskaya K. A., PhD, Senior researcher of the Department of Pathology of the Pancreas and Bile Ducts of the State Medical Institution of the MCSC named after A. S. Loginov DZM.
 

GBUZ Moscow Clinical Scientific Center named after Loginov MHD