Prognozis

Prognozis

Psödokistin nüksetme oranı %10 dolaylarındadır ve dış drenajdan sonra nüks daha sıktır. Ameliyattan sonra kistten ciddi kanama, daha ziyade kistogastrostomiden sonra görülmekle beraber nadirdir. Bununla beraber vakaların büyük çoğunluğunda psödokistin cerrahi tedavisinden sonra komplikasyon çıkmaz ve ameliyat hemen ortaya çıkan problemleri kesin bir şekilde ortadan kaldırır. Hastaların çoğu sonradan altta yatan kronik pankreatitin bir belirtisi olarak kronik ağrı çekerler.

Aranha GV et al: Evaluation of therapeutic options for pancreatic

pseudocysts. Arch Surg 1982:117:717. Aranha GV et ai: The nalure and course of eystic pancreatic

lesions diagnosed by ultrasound. Arch Surg 1983:118:486. Beebe DS et al: Management of pancreatic pseudocysts. Surg

Gynecol Obuet 1984;159:562. Bradley EL IU: Cystoduodenostomy: New perspeetives. Ann

Surg 1984:200:698. Bradley EL III, Vito RP: Mechanisms for rupture of pancreatic

pseudocysts: A biomechanical evaluation. Ann Surg

1984,200:51. Crass RA, Way LW: Acute and ehronic pancreatic pseudocysts

are different. Am J Surg 1981:142:660. Gerzuf SG et al: Percutaneous drainage of infected pancreatic

pseudocysts. Arch Surg 1984;119:888. Goulet RJetal; Multiple pancreaticpseudocystdisease. AnnSurg

1984;199:6.

28.Bölüm, Pankreas

615

Ravelo HR, Aldreîe JS: Analysis of forty-fıve patients with pseu-

docysts of the pancreas treated surgicaily. Surg Gynecol

Obstet 1979;148:735. Stabile BE, Wilson SE, Debas HT: Reduced mortality from

bleeding pseudocysts and pseudoaneurysms caused by pan-

creatitıs. Arch Surg 1983;118:45.

PROGNOZ

Prognoz

Uzunlamasına pankreatikojejunostomi kanalın genişlediği hastaların çoğunda ağnyı kaldırır; bariz olmamakla birlikte kilo alınır. Kısmi veya total pankreatektominin sonuçlan az memnuniyet vericidir ve dolayısıyla bu işlemler yapılmadan önce çöliak pleksus blokajlarına başvurmak icabeder. Bazı hastalarda pankreas yetmezliği ilerledikçe ağrı geçer.

Daimi ağrı ile birlikte bulunan ilerlemiş vakalar hariç, içkinin terki hususunda ikna edilen alkoliklerin çoğu zaman ağnsı ve nük-sedici pankreatit nöbetleri geçer. Ailevi pank-reatitte hastalığın ilerlemesi durdurulamaz ve dolayısıyla bu hastaların çoğunda ameliyat yapmak gerekir. Uzunlamasına pankreatiko-jejunostominin ailevi pankreatitteki sonuçlan fevkaladedir. Hastalann çoğunda narkotik alışkanlığı, şeker hastalığı ve beslenme bozukluğu ciddi meselelerdir.

Axon ATR et al: Pancreatography in chronic pancreatitis: International definitions. Gut 1984;25:1107.

Bradley EL III, Nasrallah SM: Fat absorption after longitudinal pancreaticojejunostomy. Surgery 1984;95:640.

BrintonMHetal: Surgical treatment of chronic pancreatitis. AmJ Surg 1984;148:754.

Cooper MJ, Williamson RCN: Drainage operations in chronic pancreatitis. Br J Surg 1984;71:761.

Eckhauser FE et al: Near-total pancreatectomy for chronic pancreatitis. Surgery 1984;96:599.

Jensen AR et al: Pattern of pain, duct morphology, and pancreatic

function in chronic pancreatitis: A comparative study. ScandJ

Gastroenterol 1984;19:334. Moore DC, Bush WH, Burnett LL: Celiac plexus block: A

roentgenographic, anatomic study of technique and spread of

solution in patients and corpses. Anesth Analg 1981;60:369. Moreaux J: Long-term follow-up study of 50 patients with pan-

creaticoduodenectomy for chronic pancreatitis. World J Surg

1984;8:346. Morrow CE et al: Chronic pancreatitis: Long-term surgical results

of pancreatic duct drainage, pancreatic resection, and near-total pancreatectomy and islet autotransplantation. Surgery

1984;96:608. Nagata A et al: A study of chronic pancreatitis by serial endos-

copic pancreatography. Gastroenterology 1981;81:884. Prinz RA et al: Combined pancreatic duct and upper gastrointesti-

nal and biliary tract drainage in chronic pancreatitis. Arch

Surg 1985;120:361. Renner IG et al: Pancreatitis associated with alcoholic liver dis-

ease: A review of 1022 autopsy cases. Dig Dis Sci 1984;29:

593. Scott HW Jr et al: Longitudinal pancreaticojejunostomy in

chronic relapsing pancreatitis with onset in childhood. Ann

Surg 1984;199:610. Williams RA, Caldwell BF, Wilson SE: Idiopathic tıereditary

pancreatitis: Experience with surgical treatment. Arch Surg

1982;117:408.

PROGNOZİS

Prognozis

Pankreasta adenokanser olan hastaların çoğu, teşhis konduktan sonra bir yıl içinde ölürler. Pankreas başı kanseri olan hasataların yaklaşık %10 unda yaşama süresi 5 yıldır, fakat bunların bazıları gerçekten tümörden kurtulmuşlardır. Gövde ve kuyruk tümörlerinin iyileştirilmesi fevkalade nadir bir durumdur.

Bodner E, Schwamberger K, Mikuz G: Cytological diagnosis of

pancreatic tutnors. World J Surg 1982;6:103. Braasch JW et al: Pancreatoduodenectomy with preservation of

thepylorus. World J Surg 1984;8:900. Carter DC: Treatınent of unresectable pancreatic cancer. Br Med

J 1982;284:1727. Cubilla AL, Fitzgerald PJ: Cancer of the exocrine pancreas: The

pathologic aspects. CA 1985;35:2. Dobelbower RR, Milligan AJ: Treatment of pancreatic cancer by

radiation therapy. World J Surg 1984;8:919. Fortner JG: Regional pancreatography for cancer of the pancreas,

ampulla, and other related sites. Ann Surg 1984;199:418. Gold EB et al: Diet and other risk factors for cancer of the

pancreas. Cancer 1985;55:460. Harvey JH, Schein PS: Chemotherapy of-pancreatic carcinoma

WorldJSurg 1984;8f935. Herter FP et al: Surgical experience with pancreatic and periam-

pullary cancer. Ann Surg 1982;195:274. Hovdenak N et al: Ultrasoünd-guided percutaneous fme-needle

aspiration cytology in pancreatic cancer. Br Med J 1982;285:

1183.

JJıse I, Isaksson G: Preoperative and operative diagnosis of pancreatic cancer. World J Surg 1984;8:846. Jalanko H et al: Comparison of a new tumour marker,

CA 19-9™, with a-fetoprotein and carcinoembryohic anti-

gen in patients vvith upper gastrointestinal diseases. J Clin

Paihol 1984;37:218. Kodama M, Tanaka T: Residual pancreatic exocrine function

before and after pancreaticoduodenectomy for periampullary

cancer. World J Surg 1984;8:335. Kummerle F, Ruckert K: Surgical treatment of pancreatic cancer.

WorldJSurg 1984;8:889. Lee YTN: Tissue diagnosis for carcinoma of the pancreas and

periampullary structures. Cancer 1982:49:1035.

624

28.Bölüm, Pankreas

Lenıt JP et al: Pancreaticoduodenaî resection: Surgical experi-ence and evaluation of risk factors in 103 patients. Ann Surg 1984;199:432.

Leung JWC et al: Coeliac plexus block for pain in pancreatic cancer and chronic pancreatitis. Br J Surg 1983:70:730.

Longmire WP Jr: Cancer of the pancreas: PaJlialive operation, VVhipple procedure, or lolal pancreatectomy. World J Surg 1984;8:872.

Mıtty HA, Efremidis SC, Yeh HC: Impac! of fine-needle biopsy on management of patients with carcinoma of the pancreas. AJR 1981:137:1119.

Moossa AR, Altorki N: Pancreatic biopsy. Surg Clin North Am 1983;63:1205.

Moossa AR et al: The place of total and extended total pancreatectomy in pancreatic cancer. World J Surg 1984;8:895.

Morrow M et al: Comparison of conventionaj surgical resection, radioactive implantation, and bypass procedures for exocrine carcinoma of the pancreas 1975-1980. AnnSurg 1984;199:1.

Nix GAJJ et al: Carcinoma of the head of the pancreas: Therapeu-tic impHcations of endoscopic retrograde cholangiopan-creatography fındings. Gasıroenterology 1984;87:37.

Papachristou DN, Fortner JG: Management of the pancreatic remnantinpancreatoduodenectomy. J SurgOncol 1981:18:1.

Perez MM et al: Assessment of weight loss, food intake, fat rhetabolism, malabsorption, and treatment of pancreatic insuf-ficiency in pancreatic cancer. Cancer 1983:52:346.

Podolsky DK: Serologic markers in the diagnosis and management of pancreatic carcinoma. World J Surg 1984;8:822.

Sanfey H, Mendelsohn G, Cameron JL: Solid and papillary neoplasm of the pancreas. Arın Surg 1983:197:272.

Sarr MG, Cameron JL: Surgical palliation of unresectable carcinoma of the pancreas. WorldJSurg 1984:8:906.

Shipley WU et al: Intraoperative electron beam irradiation for patients with unresectable pancreatic carcinoma. Ann Surg 1984:200:289.

Trede M: The surgical treatment of pancreatic carcinoma. Surgery 1985;97:28.

Van Heerden JA: Pancreatic resection for carcinoma of the pancreas: WhippJe versus total pancreatectomy—an institutionai perspective. U'prldJ Surg 1984:8:880.

Warren KW et al: Current trends in the diagnosis and treatment of carcinoma of the pancreas. Am J Surg 1983:145:813.

Wittenberg J et al: Contribution of computed tomography to patients with pancreatic adenocarcınoma. World J Surg 1984;8:831.

PROGNOZİS

Prognozis

Pankreasta adenokanser olan hastaların çoğu, teşhis konduktan sonra bir yıl içinde ölürler. Pankreas başı kanseri olan hasataların yaklaşık %10 unda yaşama süresi 5 yıldır, fakat bunların bazıları gerçekten tümörden kurtulmuşlardır. Gövde ve kuyruk tümörlerinin iyileştirilmesi fevkalade nadir bir durumdur.

Bodner E, Schwamberger K, Mikuz G: Cytological diagnosis of

pancreatic tutnors. World J Surg 1982;6:103. Braasch JW et al: Pancreatoduodenectomy with preservation of

thepylorus. World J Surg 1984;8:900. Carter DC: Treatınent of unresectable pancreatic cancer. Br Med

J 1982;284:1727. Cubilla AL, Fitzgerald PJ: Cancer of the exocrine pancreas: The

pathologic aspects. CA 1985;35:2. Dobelbower RR, Milligan AJ: Treatment of pancreatic cancer by

radiation therapy. World J Surg 1984;8:919. Fortner JG: Regional pancreatography for cancer of the pancreas,

ampulla, and other related sites. Ann Surg 1984;199:418. Gold EB et al: Diet and other risk factors for cancer of the

pancreas. Cancer 1985;55:460. Harvey JH, Schein PS: Chemotherapy of-pancreatic carcinoma

WorldJSurg 1984;8f935. Herter FP et al: Surgical experience with pancreatic and periam-

pullary cancer. Ann Surg 1982;195:274. Hovdenak N et al: Ultrasoünd-guided percutaneous fme-needle

aspiration cytology in pancreatic cancer. Br Med J 1982;285:

1183.

JJıse I, Isaksson G: Preoperative and operative diagnosis of pancreatic cancer. World J Surg 1984;8:846. Jalanko H et al: Comparison of a new tumour marker,

CA 19-9™, with a-fetoprotein and carcinoembryohic anti-

gen in patients vvith upper gastrointestinal diseases. J Clin

Paihol 1984;37:218. Kodama M, Tanaka T: Residual pancreatic exocrine function

before and after pancreaticoduodenectomy for periampullary

cancer. World J Surg 1984;8:335. Kummerle F, Ruckert K: Surgical treatment of pancreatic cancer.

WorldJSurg 1984;8:889. Lee YTN: Tissue diagnosis for carcinoma of the pancreas and

periampullary structures. Cancer 1982:49:1035.

624

28.Bölüm, Pankreas

Lenıt JP et al: Pancreaticoduodenaî resection: Surgical experi-ence and evaluation of risk factors in 103 patients. Ann Surg 1984;199:432.

Leung JWC et al: Coeliac plexus block for pain in pancreatic cancer and chronic pancreatitis. Br J Surg 1983:70:730.

Longmire WP Jr: Cancer of the pancreas: PaJlialive operation, VVhipple procedure, or lolal pancreatectomy. World J Surg 1984;8:872.

Mıtty HA, Efremidis SC, Yeh HC: Impac! of fine-needle biopsy on management of patients with carcinoma of the pancreas. AJR 1981:137:1119.

Moossa AR, Altorki N: Pancreatic biopsy. Surg Clin North Am 1983;63:1205.

Moossa AR et al: The place of total and extended total pancreatectomy in pancreatic cancer. World J Surg 1984;8:895.

Morrow M et al: Comparison of conventionaj surgical resection, radioactive implantation, and bypass procedures for exocrine carcinoma of the pancreas 1975-1980. AnnSurg 1984;199:1.

Nix GAJJ et al: Carcinoma of the head of the pancreas: Therapeu-tic impHcations of endoscopic retrograde cholangiopan-creatography fındings. Gasıroenterology 1984;87:37.

Papachristou DN, Fortner JG: Management of the pancreatic remnantinpancreatoduodenectomy. J SurgOncol 1981:18:1.

Perez MM et al: Assessment of weight loss, food intake, fat rhetabolism, malabsorption, and treatment of pancreatic insuf-ficiency in pancreatic cancer. Cancer 1983:52:346.

Podolsky DK: Serologic markers in the diagnosis and management of pancreatic carcinoma. World J Surg 1984;8:822.

Sanfey H, Mendelsohn G, Cameron JL: Solid and papillary neoplasm of the pancreas. Arın Surg 1983:197:272.

Sarr MG, Cameron JL: Surgical palliation of unresectable carcinoma of the pancreas. WorldJSurg 1984:8:906.

Shipley WU et al: Intraoperative electron beam irradiation for patients with unresectable pancreatic carcinoma. Ann Surg 1984:200:289.

Trede M: The surgical treatment of pancreatic carcinoma. Surgery 1985;97:28.

Van Heerden JA: Pancreatic resection for carcinoma of the pancreas: WhippJe versus total pancreatectomy—an institutionai perspective. U'prldJ Surg 1984:8:880.

Warren KW et al: Current trends in the diagnosis and treatment of carcinoma of the pancreas. Am J Surg 1983:145:813.

Wittenberg J et al: Contribution of computed tomography to patients with pancreatic adenocarcınoma. World J Surg 1984;8:831.