Author/Editor		Pleskovič, Alojz; Stanisavljevič, Dragan
Title		Laparoskopska kirurgija trebušne slinavke - indikacije, tehnike in naše izkušnje
Translated title		Laparoscopic surgery for pancreatic disease - indications, techniques and our experience
Type		članek
Source		Endoskopska revija
Vol. and No.		Letnik 7, št. 16-17
Publication year		2002
Volume		str. 23-7
Language		slo
Abstract		Background. The purpose of the paper was to determine the role of laparoscopy in the diagnosis and management of pancreatic diseases. Methods. Since 1995, when laparoscopic techniques were introduced in the diagnosis and assessment of local extension of malignant tumors, 24 cases of adenocarcinomas have been managed at the Department of Abdominal Surgery, University Medical Centre Ljubljana. In 10 of these, unresectable lesions were found preoperatively, and 14 had diagnostic laparoscopy prior to planned surgery Laparoscopic treatment of pancreatic diseases has been used at the Department since 2000, and 24 patients were treated by laparoscopy during that period. Results. In three of the 14 patients (21.4%), metastases of the liver and peritoneum were discovered at laparoscopy, and 11 were successfully treated by laparoscopic resection of a panceratic tumor. Gastroenteric anastomosis was done in five patients with biliary stents. Three of four patients with cystadenoma of the left pancreas were treated by laparoscopic resection of the lesion; in one patient conversion to open surgery was required because of bleeding. Laparoscopic necretomy with drain placement was accomplished in three patients with necrotizing pancreatitis. Conclusions. Laparoscopy can have an important role in the diagnosis and staging of malignant pancreatic disease. In the hands of an experienced and skilled surgeon, laparoscopy may prove a valuable technique for treating some benign and malignant diseases of the pancreas.
Summary		Namen. Namen prispevka je ugotoviti mesto laparoskopije v diagnostiki in zdravljenju bolezni trebušne slinavke. Metode. Na Kliničnem oddelku za abdominalno kirurgijo Kliničnega centra Ljubljana od leta 1995 uporabljamo laparoskopijo pri diagnosticiranju in zamejitvi malignih bolezni trebušne slinavke. V tem času smo obravnavali 24 primerov adenokarcinoma pankreasa: pri 10 primerih smo pred operacijo ugotovili, da so neresektabilni, pri ostalih 14 primerih pa smo pred načrtovano operacijonaparvili diagnostično laparoskopijo. Od leta 2000 pa uporabljamo laparoskopijo tudi v terapevtske namene pri boleznih trebušne slinavke. Pri 12 bolnikih smo laparoskopsko opravili načrtovane kirurške posege. Rezultati. Pri treh bolnikih (21,4%) od 14 smo laparoskopsko ugotovili metastaze (jetra, peritonej); 11 bolnikov smo uspešno operirali in ob laparotomiji odstranili tumor pankreasa. Pri petih bolnikih smo laparoskopsko napravili GEA, saj so imeli že vstavljen stent v žolčevodu. Pri štirih bolnikih s cistadenomi v levi polovici pankreasa smo laparoskopsko odstranili tri, pri četrtem pa smo zaradi krvavitve morali preitiv klasični poseg. Pri treh bolnikih z nekrozantnim pankreatitisom smo laparoskopsko napravili nekrektomijo in vstavili drene. Zaključki. Laparoskopija ima lahko pomembno vlogo v diagnostiki in pri ugotavljanju zamejitve malignih bolezni trebušne slinavke. Laparoskopska tehnika pa je lahko v izkušenih rokah kirurga uspešna pri zdravljenju nekaterih benignih kot tudi malignih bolezni trebušne slinavke.
Descriptors		PANCREATIC DISEASES LAPAROSCOPY