Chronic calculous pancreatitis: treatment, diet, surgery. Causes of calculous pancreatitis. Forms of calculous pancreatitis and causes of development

Today, calculous pancreatitis - common illness, most often occurring in a chronic form. More than 11% of people suffer from its symptoms and consequences. Most often, this pathology is diagnosed in women of middle and old age.

Features of the disease

Pancreatitis is an inflammation of the pancreas. Chronic calculous pancreatitis is one of its varieties. Pathology is characterized by the formation in the body of the gland of special calculi - stones of different consistency, shape and size, found in the excretory ducts of the glands and abdominal organs of a person. Stagnation and the inflammatory process occurring in the pancreas violate the chemical composition of the produced juice, resulting in solid formations.

Development calculous pancreatitis due to the process of deposition of calcium salts in the tissues of the pancreas. After a while, stones are formed from these salts, localized in the Wirsung duct. Calculi in the pancreas have a grayish-white tint, porous structure and usually consist of carbonic or phosphate lime.

Sand and small stones clog the duct, resulting in a violation of the integrity of the tissues and the expansion of the duct itself.

Why does

There is no single reason why calculous pancreatitis develops. Most often, the disease appears under the influence of a combination of the following factors:

• uncontrolled and frequent antibiotic therapy;
• excessive passion for drinks containing alcohol;
• urinary tract diseases.

The development of chronic calculous pancreatitis can be triggered by hepatitis or cholelithiasis. Common comorbidities include cardiovascular pathologies and peptic ulcer duodenum.

Symptoms

A characteristic sign of the onset of the disease is an attack of sharp pain. This symptom is similar to an attack of gallstone disease, however, with calculous pancreatitis, there is no jaundice and liquid stool. Symptoms of inflammation of the pancreas depend on the location of the stones. Stones localized in the gland itself or its head cause pain in the right upper part of the abdominal cavity. This is due to a concomitant violation of the motor function of the large intestine. If the inflammation has affected only the head of the pancreas, the focus of pain is localized under the ribs.

Inflammation of the entire pancreas often occurs with a mild pain syndrome. In this case, you should pay attention to other symptoms of pancreatitis:

• nausea and vomiting;
• stool disorders (constipation and undigested food in feces);
• weight reduction;
• excessive sweating.

Diagnostics

Calculous pancreatitis can be diagnosed both on the basis of clinical data and as a result of studies. Among them are:

1. X-ray. Examination reveals the presence of one or more small stones.
2. Laboratory. Conducting a blood serum test to determine the level of amylase (enzyme substance). In the presence of pathology, its increased content is noted. Rarely, an increase in the enzyme content can also be detected in the urine.
3. Ultrasonic. Allows you to identify the presence or absence of calculi inside the organ, as well as determine the width of the pancreatic duct.
4. Endoscopic retrograde pancreatography. This type of study is used quite rarely, if other methods do not allow an accurate diagnosis.

The probability of having calculous pancreatitis reaches 85% if the examination of the patient revealed that the concentration total bilirubin in blood serum exceeds 2 mg, amylase activity is above 1000 IU/l, and Ac AT is more than 100 IU/l.

Conservative therapy of the disease does not provide desired result. Treatment of calculous pancreatitis usually involves surgical intervention. The operation performed ensures the outflow of enzyme substances from the pancreas.

Types of surgical intervention performed depending on the severity of the lesion of the pancreas and its ducts:

• transduodenal papillosphincterotomy with concomitant drainage of the organ;
• removal of the distal part of the pancreas and its subsequent suturing into the large intestine;
• removal of the gland, performed with extensive damage to the organ and the death of the bulk of its cells;
• the imposition of an anastomosis (connection) between the loop of the middle section of the small intestine and the pancreatic duct.

Patients undergoing surgery are shown further Spa treatment. AT rehabilitation period the patient is prescribed certain procedures and adherence to a specially selected diet.

Spa therapy helps reduce painful symptoms, as well as significantly improve digestion and general condition of the body. Treatment in the sanatorium is carried out only during the period of remission and is prohibited in the acute phase of the disease.

Diet

Pancreatitis is a pathology, the treatment of which is not complete without an appointment. special diet. Its essence lies in the rejection of fatty and fried foods, smoked meats and alcoholic beverages. Salty foods should also be kept to a minimum. Difficult-to-digest carbohydrates and proteins should be reduced in the daily menu, and fat intake should be limited to 50 g per day.

If calculous pancreatitis is diagnosed, it is necessary to switch to fractional nutrition (small portions, food is taken 5 or 6 times a day). It is recommended to steam or boil food. Food should not be too cold or too hot. Fruits and vegetables are not forbidden, but it is better to use them baked. Lean meat, poultry and fish are allowed.

Can you drink with pancreatitis? herbal teas, jelly, rosehip broth, fruit and berry juices. Dairy products will also help. Providing the body necessary quantity vitamins and microelements are an important point of therapy.

ethnoscience

Recipes traditional medicine may help treat uncomplicated pancreatitis.

It should be remembered that in the acute stage, home treatment is prohibited. In addition, you can not self-medicate without the consent of your doctor.

Recipes used for the treatment of pancreatitis:

• a tablespoon of crushed dandelions (with roots, but without flowers) is poured with water and left for a day. Infusion is taken 50 ml 4 times a day;
• a teaspoon of bitter wormwood powder is poured into a glass boiled water. The resulting infusion is drunk during the day before meals;
• oat grains crushed in a meat grinder (1 cup) are poured with a liter of water. Oatmeal is boiled over low heat for 10 minutes. A small amount of the mixture is consumed before meals (no more than 100 ml at a time);
• a tablespoon of crushed blueberry leaves and bean pods is added to boiling water, and then boiled for 5 minutes. The decoction is drunk 3 times a day, 2 tbsp. spoons;
• within 14 days, 2 hours before meals, consume 200 ml of freshly squeezed potato juice, and then 200 g of kefir. Between the adoption of a fermented milk product and juice, a 5-minute break should be maintained.

Summary

Calculous pancreatitis is a serious and dangerous pathology. The outcome of the disease is often unfavorable.

With this form of inflammation of the pancreas, tissue degeneration most often occurs in malignant neoplasm. This does not happen in every case, but the presence of pathology almost always dramatically reduces a person's ability to work.

Calculous pancreatitis is a common cause of disability of the 2nd group. Self-treatment of a diagnosed disease is prohibited. You should consult an experienced specialist doctor for the appointment of adequate treatment.

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calculous chronic pancreatitis

Chronic calculous pancreatitis: treatment, diet, surgery

One type of pancreatitis is calculous pancreatitis. Let's try to figure out what causes this disease, symptoms of the disease. How is the treatment carried out? What is the forecast? Is the diet effective? Let's find answers to these and other questions.

What is the disease?

Calculous pancreatitis is an inflammatory disease of the pancreas that occurs with deposits of calcium salts in the tissues of the organ. This happens due to pathologies and violations of the chemical composition of pancreatic juice. As a result, stones are formed in the area of ​​​​the excretory duct of the organ.

Most often, these stones consist of phosphate and carbonic lime. Usually they are small in size, they look like sand of a gray-white hue, relatively low density and porous structure.

Most often, chronic calculous pancreatitis occurs in the female half of humanity, over the age of 50, and is popularly called pancreatic stones. It is extremely rare and is chronic.

Causes of the disease

Usually, calculous pancreatitis occurs due to the following reasons:

• frequent and uncontrolled use of antibiotics;
• alcohol abuse;
• cholecystitis;
• hepatitis B and C;
• -cholelithiasis;
• duodenal ulcer.

Symptoms of the disease

Symptoms of the disease directly depend on the form of the course of the disease (acute or chronic) and on the location of the stones in the pancreas itself:

1) Pain of a different nature:

• In the case when the stones have arisen and settled in the body or head of the pancreas, the pain is localized under the pit of the stomach or in the middle part of the abdomen.
• In the case when the stones are located in the body of the pancreas, pain syndrome felt in the right side of the abdomen.
• When the stones are located in the tail of the organ, pain is felt on the left in the hypochondrium.
• In the case when the stones hit the entire gland, the patient is tormented by girdle pain.

2) Change in the nature of the chair. Usually the patient suffers from constipation. The stool may be mushy. There may also be undigested food in the stool.

3) Frequent nausea and in some cases vomiting.

4) Increased sweating.

5) Slimming.

6) Increased heart rate.

If the stones are located in the entire pancreas, diabetes begins to develop. In this case, the pain is mild or absent.

Diagnosis of the disease

To make an accurate diagnosis, the doctor uses the following diagnostic methods:

• Ultrasound procedure. Allows you to determine the width of the pancreatic duct and the presence or absence of stones in it.
• Laboratory tests. In the analysis of blood and urine, an increase in amylase occurs.
• X-ray examination. Allows you to view one or more small stones.
• Endoscopic retrograde pancreatography. This method is used as an additional method when the above methods did not give effective results.

Treatment of the disease

Treatment of calculous pancreatitis must be prescribed by a doctor, since this is a very serious and dangerous disease. Methods of treatment depend directly on the severity of the course of the disease.

1) The mode of sanatorium-resort.

2) Complex of medical procedures:

• - internal reception mineral waters (drinking treatment, gastric lavage, rectal procedures, drainage of the biliary tract and others).
• - external intake of mineral waters (reception of mineral baths).
• - mud treatment.
• - physical therapy and climatotherapy.

3) Physiotherapy:

• - UHF therapy;
• - diathermy;
• - paraffin;
• - Sollux and others.

4) Medical nutrition.

Most often, this disease is treated with surgical method. If there are symptoms of internal and exocrine insufficiency, the patient is prescribed insulin injections. As mentioned above, the most effective method, which is used to treat calculous pancreatitis is considered operational method. Target surgical operation- create good conditions for the outflow of juice in the gastrointestinal tract from the pancreas itself.

Depending on how affected the gland with ducts, the following types of surgical interventions are performed:

• Subtotal pancreatectomy (resection of the pancreas). This operation prescribed when a large lesion of the pancreas occurs and dies most of organ cells.
• Transduodenal papillosphincterotomy, in which the pancreatic duct is drained.
• Resection of the distal part of the pancreas and sewing it into the colon.
• Anastomosis between the loop of the small intestine and the pancreatic duct.

Methods and means of traditional medicine

With the permission of the attending physician, for the treatment of calculous pancreatitis in the stage of stable remission, you can use folk methods.

So, commonly used the following means not traditional medicine:

• walnut tincture";
• juice from fresh potatoes and carrots;
• tincture of chamomile flowers, St. John's wort, wormwood, mint leaves and yarrow;
• decoction or powder of aspen bark;
• a decoction of the roots and leaves of dandelions;
• a decoction of bean pods and blueberry leaves;
• decoction of oatmeal;
• bitter wormwood tincture;
• powdered stems of bittersweet nightshade. Take 15 minutes before meals three times a day. In the case of the appearance of sweet sensations, we can conclude about severe inflammation pancreas. If such a sensation occurs after 15 minutes, then the disease proceeds in a weak form.
• a mixture of calamus roots, dandelion, nettle, mint leaves, thyme and hop cones, honey or jam;
• decoction of anise fruits, corn silk, herbs of celandine, tricolor violet root and dandelion, herbs of bird mountaineer.

Diet

In calculous pancreatitis, a very important point is proper nutrition and dieting. From the diet it is necessary to exclude all fried and sweet. Food should be fractional, small portions. Food should be of medium temperature (neither too hot nor too cold).

Let's get acquainted with the products allowed for this ailment:

• lean poultry, fish and meat.
• low-fat cottage cheese. It can be used in fresh Or make casseroles out of it.

Consumed dishes are preferably steamed or boiled. During periods of exacerbation of the disease, it is recommended to bake vegetables or fruits.

• herbal teas;
• rosehip decoction;
• various kissels.

Here is an approximate diet menu for this disease:

• cookies and dry bread;
• grated soups cooked in low-fat broth;
• low-fat dairy products;
• casseroles;
• omelets. For cooking, use only protein.

An excellent breakfast can be buckwheat, semolina or oatmeal. But porridge should be consumed only in grated form. Fruits are allowed for this pathology only non-acidic varieties.

Disease prognosis

With calculous pancreatitis, specialists usually leave an unfavorable prognosis, since this ailment can often degenerate into a malignant tumor. Also, with this disease, the patient's working capacity usually decreases, for this reason, in some cases, a disability group is assigned.

Timely diagnosis, proper nutrition, rejection of bad habits will avoid the development of many dangerous pathologies and complications.

1pankreatit.ru

Chronic calculous pancreatitis - symptoms, treatment, surgery, diet

The cause of the development of calculous pancreatitis is a violation of the chemical composition of pancreatic juice caused by inflammatory processes in it or stagnation. As a result of these processes, the formation of stones in excretory duct pancreas.

As a rule, they consist of lime carbonate, have a porous structure and can be presented in the form of sand or small stones that clog the duct, which invariably entails its expansion, as well as a violation of the integrity of the tissues. As a result, inflammatory processes are formed in the pancreatic parenchyma, leading to the appearance of abscesses and ulcerations.

The manifestation of the disease begins with an attack acute pain similar to an attack of gallstone disease. Distinctive features calculous pancreatitis is the absence of jaundice and diarrhea.

The correct diagnosis can be made using X-ray, endoscopic and ultrasound examinations. As a rule, in the picture you can clearly see one or more stones that look like champagne splashes. It is important not to confuse stones with lymph nodes. To confirm the diagnosis of chronic calculous pancreatitis or, on the contrary, to refute it, you can use endoscopic examination.

The severity of the patient's condition and the tactics of his treatment in chronic calculous pancreatitis depends on the location of the stones in the pancreas. So, for example, when they are located directly in the body of the gland or in its head, an acute pain syndrome, pain in the large intestine and its dyskinesia are observed. In a laboratory blood test, an increase in amylase is observed, as well as an increase in the acidity of gastric juice.

In the event that stones are found in the entire pancreas, diabetes mellitus develops. In this case, the pain syndrome can be expressed weakly or absent altogether.

It should be noted that calculous pancreatitis is relatively rare and in most cases is chronic. The disease has an unfavorable prognosis, the main cause of which is malignant transformation of pancreatic tissues.

The main method of treatment is based on surgical intervention. In diabetes mellitus caused by calculous pancreatitis, replacement therapy is indicated.

Symptoms of a disease such as calculous pancreatitis depend primarily on the location of the stones. If they are located on the head or in the body of the pancreas, then the main symptom will be a feeling of pain in the pit of the stomach or in the right upper area belly. In the case when the stones are located near the tail of the pancreas, pain occur in the left hypochondrium. In all other cases, the pain will be girdle in nature.

The symptoms of calculous pancreatitis include not only a feeling of pain, but also changes in the stool. Its consistency becomes mushy with inclusions of particles of undigested food and a foamy substance. The stool has an unpleasant characteristic odor.

Surgery for acute calculous pancreatitis

Acute calculous pancreatitis is one of the most serious dangerous diseases, the treatment of which is mainly carried out surgically. In cases of detection of intrasecretory external insufficiency The patient is given insulin injections.

The prognosis for such a disease is most often unfavorable, i.e., in most cases, the process of malignant degeneration starts. In other forms of the disease, the frequency of this process is several times lower.

After the operation, patients with acute calculous pancreatitis should undergo rehabilitation in one of the special sanatoriums, on the basis of which the procedure will be organized. necessary procedures and following a healthy diet.

Diet for calculous pancreatitis

Like all other forms of this disease, this one also requires patients to follow a certain diet. The menu of patients should not contain anything fried and sweet. All meals should be served warm (hot or cold food will only aggravate the condition of the pancreas). Meals should be carried out according to the rule "often, but little", the ideal option would be five to six meals a day.

The diet menu for chronic calculous pancreatitis can be represented by dry bread and biscuits, grated soups prepared on the basis of low-fat meat broth, low-fat fish or boiled poultry meat. The diet may contain low-fat dairy products, casseroles, protein omelettes.

An ideal option for morning meals can be porridge made from buckwheat, oatmeal or semolina. At the same time, it is worth noting that even porridge should be served on the table in a grated form. As for vegetables, they should be consumed after pre-cooking. Fruits can also be included in the menu, but they must be non-acidic.

zhkt.guru

Causes and treatment of calculous pancreatitis

Calculous pancreatitis is a disease of the pancreas in which calcium salts accumulate in it. Such processes occur due to a change in the chemistry of the gland juice, stones are formed that close the exit from the organ. They are stones from a lime mixture. They are small size, porous. Such a disease most often occurs after 50. What causes the disease, what are the symptoms and how to treat?

The reasons

There is no specific reason why calculous pancreatitis develops. The disease occurs due to a combination of such factors:

• excessive drinking;
• frequent use of antibiotics;
• ulcer in the duodenum;
• gallbladder disease;
• hepatitis B and hepatitis C;
• problems in the urinary tract.

Symptoms

Symptoms of such inflammation of the pancreas depend on the location of the stones and their size. If they lie in the head or the organ itself, it hurts from the top right in the abdomen because the motor function of the large intestine is impaired. If only the head is inflamed - pain under the ribs. When conducting tests, it can be observed that the acidity of gastric juice is above normal, the level of amylase in the urine and blood increases.

If pancreatitis covers the entire pancreas, tests will show secretory insufficiency. Wherein pain little perceptible. A symptom of calculous pancreatitis is stool disorders, constipation often occurs. The consistency of feces is mushy, may have the remains of undigested food. Chronic calculous pancreatitis may be accompanied by symptoms such as nausea and vomiting, as well as weight loss and excessive sweating.

Treatment

With calculous pancreatitis, self-medication is prohibited. Proper Treatment only a doctor can prescribe, depending on the stage of the disease and its severity. In this case, the specialist takes into account whether there are symptoms that indicate intrasecretory and exocrine insufficiency. If they exist, they need to be replaced. Treatment consists in prescribing drugs: insulin, pancreatin or others. enzyme preparations. During remission of chronic calculous pancreatitis, a spa treatment may be recommended.

During treatment, the doctor will definitely prescribe a diet, in last resort- surgical intervention.

Folk remedies

In chronic pancreatitis, the use of traditional medicine must be agreed with the attending physician. It is forbidden to use them in the acute stage. They can only be used in a mild form of the disease that is in remission.

Grandma's recipes for the treatment of calculous pancreatitis:

• Aspen bark. Decoction: 1 tablespoon up to 4 times a day. Powder: half a gram per day for 3 days before lunch.
• Dandelions. Grind a plant without flowers with roots, you should get a tablespoon. Pour in water and let stand for a day. Take 4 times a day, 50 ml.
• Blueberries and bean pods. The leaves of the plant must be crushed together with the bean pods. Pour a tablespoon into boiling water and boil for 5 minutes. Drink three times a day up to 2 tbsp. l.
• Oats. Twist the grains of the plant with a meat grinder. You should get a glass of gruel. Pour it with a liter of water and cook over low heat for 10 minutes. Consume up to 100 ml before meals.
• Wormwood. A pinch of powder is taken orally a quarter of an hour before meals twice a day. You can use infusion. For this, 1 tsp. powder is poured with a glass of boiled water. The liquid must be drunk during the day before meals.
• Potato juice. You need to drink up to 200 ml of juice, and after 5 minutes - kefir (200 g). This mixture should be taken 2 hours before meals for two weeks.
• Oat flour. 100 g boil. It will take 60 min. Later, add a quarter of a spoon of salt, 4 tsp. cherry syrup, 4 tsp. nuts (walnuts chopped). Bring everything to a homogeneous mixture. Then divide into 3 equal parts. Eat throughout the day before meals.

Surgical intervention

With this type of chronic pancreatitis, the most effective treatment considered a surgical procedure. With its help, they help to ensure the outflow of enzymes from the pancreas. There are several types of this procedure:

• impose an anastomosis;
• make a resection of the pancreas and sew into the small intestine;
• conduct transudenal papillosphincterotomy and drain the pancreatic ducts;
• cut out part of the gland.

diet therapy

In any case, with chronic pancreatitis, it is necessary to eat diet food. All hazards, for example, fried, smoked, salted, foods with chemical composition must be completely excluded. You need to eat many times in small portions. Food should be a little warmer room temperature, cold and hot is impossible. are allowed lean varieties fish and meat, cottage cheese, baked vegetables. Steam, bake, or boil.

Forecast

Often chronic pancreatitis develops into a malignant disease. It limits the patient's ability to work, so group 2 disability is not uncommon.

pishchevarenie.ru

Etiology and course of calculous pancreatitis

A disease such as calculous pancreatitis can bring a lot of problems to a person's life. It is characterized by inflammation of the pancreas due to the formation of deposits of calcium salts in it. They condense, forming porous stones in the ducts of the organ, and cause significant discomfort.

Reasons for development

Any problems with the digestive tract do not arise spontaneously. They are provoked by several factors at once, which have a gradual destructive effect on the body. The causes of the calculous form of pancreatitis can be:

• liver pathology, in particular hepatitis B and C;
• gallbladder disease;
• stomach and duodenal ulcer;
• vascular pathology and connective tissue;
• malnutrition;
• bad habits;
• taking medications;
• ecology.

A person's lifestyle plays a special role. Polluted city air, alcohol abuse, erratic diet - this is a serious burden for the pancreas. These same factors worsen the condition of adjacent organs. Incorrect or untimely treatment of gastrointestinal problems, long-term use antibiotics provoke a violation of metabolic processes in tissues. As a result of all this, calculi are formed in the pancreatic ducts, accompanied by inflammation.

Symptoms and manifestations

The manifestations of this form of the disease are somewhat different from the usual course of inflammation of the pancreas.

Often, the symptoms of calculous pancreatitis are less pronounced and largely depend on the localization of stones in this organ.

Most often, patients complain about:

• pain in the hypochondrium and middle part of the abdomen;
• nausea, sometimes vomiting;

• stool disorders, constipation;
• change in stool consistency to frothy bad smell containing inclusions of undigested food;
• increased acidity of gastric juice;
• increased sweating;
• weight loss.

Pain is directly related to the location of the stones. The inflamed head responds with pain in the hypochondrium. If the stomach hurts on the right, the body of the pancreas is affected, on the left, its tail. With a complete lesion of the gland, the discomfort becomes girdle.

The inflamed organ puts pressure on the intestines, which provokes discomfort in the central part of the abdomen and stool disorders. Calculous pancreatitis also affects the secretion of gastric enzymes. It is this phenomenon that explains the incomplete digestion of food and the presence of its particles in the feces.

Forms of the disease

The severity of symptoms and further treatment to a certain extent depend on the form of the disease. There are acute and chronic calculous pancreatitis.

acute form disease is characterized by an intense manifestation of symptoms. The patient feels severe pain, which may be associated with the displacement of stones, nausea, up to vomiting. Body temperature may rise and fever may occur. AT this case immediate medical intervention.

The chronic form of calculous pancreatitis is characterized by a weak manifestation of symptoms. During periods of remission, they are almost completely absent. Deposits of calcium salts in this case have small volumes, therefore they are not so dangerous for humans. However, they continue to accumulate unless appropriate treatment and prevention measures are taken.

Exacerbation of chronic pancreatitis occurs when using junk food, certain drugs, or alcohol. Stress also contributes its share, so experiences should be minimized - they worsen the condition of the entire gastrointestinal tract. In the presence of other pathologies of the digestive or hepatobiliary systems, the development of such diseases entails the resumption of inflammation of the pancreas.

Diagnostics and prognosis

Diagnosis of calculous pancreatitis is carried out in a complex manner. First of all, you need to consult a gastroenterologist. The doctor conducts an initial examination and interview of the patient to find out to what extent the disease manifests itself. To clarify some points, you may also need to consult an endocrinologist.

To determine the current state of the pancreas, blood and urine tests, a coprogram, and ultrasound are prescribed. You may also need diagnostic methods such as angiography, retrograde cholecystopancreatography, CT. Based on the results obtained, a necessary treatment.

The prognosis of recovery depends on the degree and form of the pathology, as well as what treatment was prescribed.

A full examination is carried out if the patient's condition allows. In the event of an attack of pancreatitis, you need to call an ambulance and provide emergency assistance. In general, any lesion of the pancreas is serious danger for a person. AT rare cases possible development oncological diseases.

Treatment Methods

Treatment of calculous pancreatitis consists of several directions. With a moderate course of the disease are used:

• Medicines. Medicines are used on a limited basis. Their goal is to eliminate symptoms (pain, nausea), normalize stool and digestive process, stimulation of the breakdown of deposits and the removal of inflammation.

• Folk remedies. Auxiliary treatment to the main therapy. The following remedies have proven themselves well: chamomile decoction, St. John's wort tincture, carrot juice, yarrow.
• Physiotherapy. It is aimed at restoring the functioning of organs, treating concomitant diseases and accelerating tissue regeneration.
• Sanatorium-resort procedures. Doctor prescribes baths, reception mineral water suitable composition, establishes a valid menu.

If the patient's condition is severe, the stones interfere with the normal functioning of the organ or provoke necrotic processes, urgent surgical intervention is necessary. The operation for calculous pancreatitis is aimed at restoring the outflow of gland secretion. To do this, drainage of the tubules is carried out with the removal of deposits of calcium salts. If the organ has begun to collapse, an operation is performed to remove dead or severely damaged areas of the gland.

Preventive actions

Treatment must be supplemented with measures to prevent the occurrence of recurrent attacks. This is especially true in chronic pancreatitis.

The list of preventive measures includes:

• reducing alcohol consumption;
• minimization of drug effects on the body;
• balanced balanced diet;
• to give up smoking;
• avoidance stressful situations;
• complete rest.

The main emphasis, both in treatment and prevention, is on nutrition.

With an exacerbation of the disease, food is taken in processed form: pureed boiled vegetables, chicken soufflé, hateful soups. Less salt should be used, and fatty, smoked, fried and sweet should be completely abandoned.

With pancreatitis and cholecystitis menu

Calculous pancreatitis is a disease of the pancreas in which calcium salts accumulate in it. Such processes occur due to a change in the chemistry of the gland juice, stones are formed that close the exit from the organ. They are stones from a lime mixture. They are small and porous. Such a disease most often occurs after 50. What causes the disease, what are the symptoms and how to treat?

The reasons

There is no specific reason why calculous pancreatitis develops. The disease occurs due to a combination of such factors:

• excessive drinking;
• frequent use of antibiotics;
• ulcer in the duodenum;
• gallbladder disease;
• hepatitis B and hepatitis C;
• problems in the urinary tract.

Symptoms

Symptoms of such inflammation of the pancreas depend on the location of the stones and their size. If they lie in the head or the organ itself, it hurts from the top right in the abdomen because the motor function of the large intestine is impaired. If only the head is inflamed - pain under the ribs. When conducting tests, it can be observed that the acidity of gastric juice is above normal, the level of amylase in the urine and blood increases.

If pancreatitis covers the entire pancreas, tests will show secretory insufficiency. At the same time, painful sensations are little palpable. A symptom of calculous pancreatitis is stool disorders, constipation often occurs. The consistency of feces is mushy, may have the remains of undigested food. Chronic calculous pancreatitis may be accompanied by symptoms such as nausea and vomiting, as well as weight loss and excessive sweating.

Treatment

With calculous pancreatitis, self-medication is prohibited. Only a doctor can prescribe the correct treatment, depending on the stage of the disease and its severity. In this case, the specialist takes into account whether there are symptoms that indicate intrasecretory and exocrine insufficiency. If they exist, they need to be replaced. Treatment consists in prescribing drugs: insulin, pancreatin or other enzyme preparations. During remission of chronic calculous pancreatitis, a spa treatment may be recommended.

During treatment, the doctor will definitely prescribe a diet, in extreme cases - surgical intervention.

In chronic pancreatitis, the use of traditional medicine must be agreed with the attending physician. It is forbidden to use them in the acute stage. They can only be used in a mild form of the disease that is in remission.

Grandma's recipes for the treatment of calculous pancreatitis:

• Aspen bark. Decoction: 1 tablespoon up to 4 times a day. Powder: half a gram per day for 3 days before lunch.
• Dandelions. Grind a plant without flowers with roots, you should get a tablespoon. Pour in water and let stand for a day. Take 4 times a day, 50 ml.
• Blueberries and bean pods. The leaves of the plant must be crushed together with the bean pods. Pour a tablespoon into boiling water and boil for 5 minutes. Drink three times a day up to 2 tbsp. l.
• Oats. Twist the grains of the plant with a meat grinder. You should get a glass of gruel. Pour it with a liter of water and cook over low heat for 10 minutes. Consume up to 100 ml before meals.
• Wormwood. A pinch of powder is taken orally a quarter of an hour before meals twice a day. You can use infusion. For this, 1 tsp. powder is poured with a glass of boiled water. The liquid must be drunk during the day before meals.
• Potato juice. You need to drink up to 200 ml of juice, and after 5 minutes - kefir (200 g). This mixture should be taken 2 hours before meals for two weeks.
• Oat flour. 100 g boil. It will take 60 min. Later, add a quarter of a spoon of salt, 4 tsp. cherry syrup, 4 tsp. nuts (walnuts chopped). Bring everything to a homogeneous mixture. Then divide into 3 equal parts. Eat throughout the day before meals.

The digestive system is the backbone of the body. Failure of any of the organs will have an indispensable negative impact on the body, leading to serious consequences. Often people seek help in the treatment of such diseases: gastritis, pancreatitis, appendicitis, cholecystitis. The article deals with the disease pancreatitis, or rather, its variety - calculous pancreatitis.

The general definition of the disease is the inflammatory process to which the pancreas is susceptible. Calculous pancreatitis is a disease accompanied by the deposition of calcium salts in the form of pebbles or sand inside the organ. This is explained by an imbalance in the chemical content of pancreatic juice. Stones or sand close the duct, preventing the release of the secret. Often the disease occurs in people of retirement age.

Keep in mind, the doctor makes the diagnosis. After complete examination, including endoscopic, when the diagnosis of "calculous pancreatitis" is confirmed, they begin treatment. How to understand that there is a risk of development similar disease? Manifested by individual features:

• severe pain in the abdomen. Depending on the location of the formed stones, they are felt in different areas;
• indigestion: there are constipation, stools in the form of porridge, with traces of undigested food;
• weight loss;
• excessive sweating;
• characteristic odor from the mouth.

If you experience these symptoms, you need to tell your doctor. Even with one sign, it does not hurt to diagnose, on early stage the development of the disease will be able to do less damage to the body.

Causes of calculous pancreatitis

To similar condition gives several points that are a consequence of each other. Calculous pancreatitis is considered a neglected form of the disease, when the body cannot withstand a huge number of loads.

Consider the levers that give impetus to the development of the disease:

1. Uncontrolled consumption of alcoholic products;
2. Overtreatment with antibiotics;
3. Current diseases of hepatitis B and hepatitis C, gallbladder and biliary tract;
4. duodenal ulcer;
5. The consequences of the treatment of injuries, infections, surgical operations;
6. Problems with blood vessels, heart.

Treatment of calculous pancreatitis

Treatment starts with full control and prescribing the procedures of the supervising physician. Self-medication is contraindicated. Calculous pancreatitis is characterized by acute and chronic form of the disease. Acute course the disease is rare, considered dangerous to humans. An operation under the supervision of an experienced surgeon will be able to solve the problem, when it is necessary to urgently remove the formed stones. Recovery in this case will take a long time. It is advisable to undergo a rehabilitation course in special centers, sanatoriums or boarding houses. Often after the operation there are consequences in the form of the transition of the disease to oncology. A person with a similar diagnosis is largely limited, disability is assigned, more often group 2.

Chronic calculous pancreatitis is common, more common than other types. The pathology is characterized by pain in the form of spasms, nausea, vomiting. This form of the course of the disease is no less dangerous than acute. The consequences and rehabilitation remain similar. Treatment does not always consist of surgical intervention. Conservative methods are possible, aiming at churn, splitting possibilities, and inadmissibility of growth. Almost constantly in the treatment of calculous pancreatitis, physiotherapeutic methods are also used.

Diet for calculous pancreatitis

Whatever the course of the disease, the treatment of calculous pancreatitis begins with a strict diet. First of all, fried and smoked dishes, salty and spicy, fast food, and alcoholic products are excluded from the diet. Food should not contrast sharply in temperature.

Fruits and vegetables remain. Vegetables are not eaten raw, fruits are shown to be non-acidic. It is desirable to use fermented milk products, better fat-free, vegetable soups, jelly, herbal teas. For breakfast, a protein omelet, cereals (semolina, buckwheat, oatmeal) are ideal. The dish will need to be ground first, choose milk with minimum fat content. Products should be stewed, boiled or steamed. A prerequisite will consume large amounts of water. The recommendations for the diet of the attending physician will have to be strictly followed. This will be the key to recovery.

After the treatment, when the moment of recovery or remission comes, it is possible to use folk recipes to maintain health.

Folk recipes for the treatment of calculous pancreatitis

These methods of treatment are used only with the consent of the attending physician, some prescriptions may be advised by the doctor. Aimed at strengthening the result after traditional medicine, to minimize the risk of an exacerbation of the disease or the neglect of the disease.

Consider well-known and proven recipes:

Not all known methods of preparing medicinal potions are listed here. Remember that you can use folk methods if there is no intolerance and allergic reactions to the components of the manufactured mixtures. Folk recipes do not replace the main treatment, but will become additional.

I would like to add that the prevention and prevention of the disease are considered the best way avoidance. Do not ignore the first symptoms that appear when you feel unwell, drowning them out with pills, self-medicating. This practice can relieve the symptoms, but not treat the cause. Useful rejection of harmful addictions, reduction physical activity and adherence to healthy eating habits.

The invention relates to medicine, namely to surgical gastroenterology, and can be used in the treatment of patients with chronic calculous pancreatitis.

Patients with chronic calculous pancreatitis undergo resection and drainage operations, the purpose of which is to eliminate hypertension of the main pancreatic (Wirsung) duct and, as a result, relieve pain. Drainage operations, during which decompression is achieved by the imposition of pancreatoenteroanastomosis, are organ-preserving in nature and are a common and pathogenetically substantiated method of treating chronic calculous pancreatitis (Shalimov A.A., Grubnik V.V., Horowitz D., Zaichuk A.I., Tkachenko A. .I. Chronic pancreatitis. - Kyiv: Health, 2000. - S. 166).

A known method of surgical treatment of chronic pancreatitis (patent SU 445414, publ. 05/28/1975) - excision of a quadrangular flap of the anterior wall of the pancreas up to 10 cm long, including the Wirsung duct with adjacent areas of the parenchyma, followed by the imposition of a longitudinal pancreatoenteroanastomosis. Moreover, between the afferent and outlet loops of the small intestine, then enteroanastomosis is performed with a plug on the afferent loop. The disadvantage of this method is the reflux of intestinal contents into the ductal system of the pancreas.

A method for internal drainage of the ductal system of the pancreas is proposed, in which 2-4 deep longitudinal incisions of the anterior wall of the gland are made to open the Wirsung duct, after which the formation of pancreatoenteroanastomosis is performed (Taylor R.H., Bagley F.H., Braasch J.W., Warren K.W. Ductal drainage or resection for chronic pancreatitis American Journal of Surgery 1981; 141(1): 28-33). The disadvantage of this method is excessive trauma when applying longitudinal incisions and inadequate drainage of the ductal system.

As a prototype, the above method was used by Propp A.R., Poluektov V.L. Their method of longitudinal pancreaticoenteroanastomosis (patent RU 2296517, publ. 04/10/2007), in which the pancreatic parenchyma is excised throughout the longitudinal incision at equal distances in the form of triangular fragments with bases on the longitudinal incision and vertices facing the upper and lower edges of the pancreas glands. However, this method is not without such disadvantages as the possibility of massive bleeding due to the intersection of vessels located along the anterior and lateral surfaces of the pancreas, and increased traumatization of the pancreatic parenchyma, leading to endo- and exocrine insufficiency.

All of the above methods are modifications of the longitudinal pancreatojejunostomy operation described by Puestow Ch., Gillesby W. (Retrograde surgical drainage of pancreas for chronic relapsing pancreatitis. A.M.A. Archives of Surgery. 1958; 52: 898-907) and improved by Partington P.F., Rochelle R.E.L. (Modified Puestow procedure for retrograde drainage of the pancreatic duct. Annals of Surgery. 1960; 152(6): 1037-1043). This surgical intervention is the closest way to the declared one. The main steps of this operation are as follows. After the implementation of the median laparotomy, dissection of the gastrocolic ligament, revision of the pancreas, the pancreatoduodenal complex is mobilized, the Wirsung duct is punctured. Then proceed to the opening of the duct with a scalpel, after which the duct is taken on the holders, which stitch the entire thickness of the parenchyma of the dissected gland. A grooved probe is inserted into the Wirsung duct and further opening of the duct is made along it. Next, a Y-shaped anastomosis is applied, a long loop of the jejunum (30-40 cm), turned off according to Roux, is used. The crossed end of the jejunum mobilized according to Roux is stitched with a hardware or manual suture and then brought to the distal part of the pancreas to perform a directly longitudinal pancreatojejunoanastomosis, which is applied isoperistaltically. The disadvantage of this method in the treatment of patients with chronic parenchymal calculous pancreatitis is insufficient drainage of the ductal system of the pancreas due to limited removal of stones in the parenchyma of the gland.

The technical result of using the claimed method is to eliminate these deficiencies and the presence of advantages: 1) the possibility of crushing and removing stones both in the Wirsung duct and in the pancreatic parenchyma; 2) the possibility of crushing and removing stones in the distal part of the duct, then the line of dissection of the Wirsung duct in order to improve the outflow from the tail of the pancreas; 3) the possibility of crushing and removing stones in the proximal part of the Wirsung duct before passing the instrument at the mouth of the main pancreatic duct in order to improve the outflow from the ducts of the 1st order of the head of the pancreas; 4) the ability to remove part of the top and bottom wall the Wirsung duct to open the ducts of the I-II order. The above advantages of the claimed method make it possible to reduce indications for performing resection operations, including Beger's operation.

The problem to be solved by the claimed invention is the development effective way surgical treatment of chronic calculous pancreatitis, which will eliminate severe pain in most patients, which, in turn, will significantly reduce material costs for further treatment and rehabilitation of such patients.

The task is achieved due to: 1) the practical implementation of the principle of double drainage, which consists in the possibility of outflow of pancreatic juice both through the longitudinal panreatojejunoanastomosis and through the restored mouth of the Wirsung duct, 2) opening the lumen of the Wirsung duct at the border of the head and body of the pancreas, allowing a longer time not to obliterate the pancreatojejunostomy.

The method of surgical treatment of chronic calculous pancreatitis, confirmed by ultrasound and computed tomography, is performed as follows. An upper median laparotomy is performed. By dividing the gastrocolic ligament, access is made to the lesser omentum. The duodenum is mobilized according to Kocher and the lower edge of the body of the pancreas is mobilized. Perform intraoperative ultrasound of the pancreas. Under ultrasound control, a puncture and opening of the Wirsung duct is performed, the main pancreatic duct is dissected up to 8-10 cm long. An ultrasonic dissector crushes and removes stones in the duct and its walls, after which part of the upper and lower walls of the Wirsung duct are removed with the opening of ducts I-II- order. An ultrasonic dissector crushes and removes calculi in the distal part of the pancreas beyond the duct dissection line, in the lumen of the proximal part of the Wirsung duct before the instrument passes through the mouth of the main pancreatic duct. At the border of the head and body of the gland, the opened Wirsung duct is expanded to 1.5-1.8 cm, similar to Frey's operation. A loop of the jejunum is isolated 15-20 cm from the ligament of Treitz, mobilized and transected. Impose a longitudinal pancreatojejunoanastomosis side-to-side. The parenchyma and the pancreatic capsule and all layers of the jejunum wall are captured by the first row with a continuous suture, the capsule of the gland and the sero-muscular membrane of the jejunum are captured by the second row. A window in the transverse mesentery is sutured with several sutures. colon. An inter-intestinal anastomosis is applied according to Roux distal to the pancreatojejunoanastomosis by 40-45 cm. Then drainage is performed. abdominal wall through the counter-opening, suturing the wound of the abdominal wall

Clinical example. Patient P., aged 56, was admitted with a diagnosis of Chronic pancreatitis. Considers himself ill for 4 years. Repeatedly treated for exacerbations of chronic pancreatitis. Relapses of the disease up to 3 times a year. Over the past year, she notes an increase in exacerbations, an increase in pain. During the examination (ultrasound, CT scan) revealed chronic calculous ductal and parenchymal pancreatitis. 5 days after admission, the patient underwent an operation - longitudinal pancreatojejunostomy on the turned off loop of the jejunum according to Roux. Upper median laparotomy. By dividing the gastrocolic ligament, access was made to the lesser omentum. Mobilization of the duodenum according to Kocher. Mobilization of the lower edge of the body of the pancreas. Calculi were determined by palpation in the pancreatic parenchyma, after which intraoperative ultrasound of the pancreas was performed. Under ultrasound control, a puncture and opening of the Wirsung duct was performed, the main pancreatic duct was cut up to 8 cm long. An ultrasonic dissector performed fragmentation and removal of stones in the duct and its walls, after which part of the upper and lower walls of the Wirsung duct was removed with the opening of the lumen of the ducts I-II- order. An ultrasonic dissector performed fragmentation and removal of calculi in the distal part of the pancreas beyond the duct dissection line, in the lumen of the proximal part of the Wirsung duct before the instrument passed through the mouth of the main pancreatic duct. On the border of the head and body of the gland, the opened Wirsung duct was expanded to 1.5-1.8 cm, similar to Frey's operation. A loop of the jejunum was isolated 15-20 cm from the ligament of Treitz, it was mobilized and transected. A side-to-side longitudinal pancreatojejunoanastomosis was applied behind the colon. A window in the mesentery of the transverse colon was sutured with several sutures. Imposed inter-intestinal anastomosis according to Roux distal to pancreatojejunoanastomosis by 40-45 cm. Drainage of the abdominal wall, suturing the wound of the abdominal wall. The postoperative period was uneventful, the wound healed by primary intention.

Thus, the method according to the invention allows:

1) crush and remove calculi both in the Wirsung duct and in the pancreatic parenchyma;

2) crush and remove calculi in the distal part, then the line of dissection of the Wirsung duct in order to improve the outflow from the tail of the pancreas;

3) crush and remove calculi in the proximal part of the Wirsung duct before passing the instrument at the mouth of the main pancreatic duct in order to improve the outflow from the ducts of the 1st order of the head of the pancreas;

4) remove parts of the upper and lower walls of the Wirsung duct in order to open the ducts of the I-II order;

5) expand the opened Wirsung duct at the border of the head and body up to 1.5-1.8 cm according to the type of Frey's operation, which allows the pancreatojejunoanastomosis not to be obliterated for a longer time.

A method for the surgical treatment of chronic calculous pancreatitis by opening and dissecting the main pancreatic duct, removing stones from the lumen of the duct and the pancreatic parenchyma, applying a retrocolic longitudinal pancreatojejunoanastomosis and Roux-en-Y interintestinal anastomosis, characterized in that an ultrasonic dissector removes part of the upper and lower walls of the main pancreatic duct with opening of the lumen of the ducts of the I-II order, crushing and removal of calculi in the duct and pancreatic parenchyma, crushing and removal of calculi in the tail of the pancreas, then the line of dissection of the duct, crushing and removal of calculi in the proximal part of the duct before passing the instrument at the mouth of the main pancreatic duct, after which, at the border of the head and body of the pancreas, the opened main pancreatic duct is expanded to 1.5-1.8 cm according to the Frey operation.

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