Kronik Pankreatitte Cerrahi
Özet
Kronik pankreatit, pankreasın ilerleyici ve geri dönüşsüz inflamatuar bir hastalığı olup, ekzokrin ve endokrin fonksiyon kayıpları ile şiddetli karın ağrısı, steatore ve Tip 3 diyabet gibi semptomlarla seyreder. Teşhiste bilgisayarlı tomografi, MRCP ve endoskopik ultrasonografi gibi yöntemler kullanılırken, tedavi yaklaşımı medikal takipten endoskopik müdahalelere (ERCP/EUS), ESWL ve cerrahi seçeneklere kadar uzanır. Cerrahi tedaviler morfolojik yapıya göre DuVal, Puestow-Gillesby ve yaygın kullanılan Partington-Rochelle gibi dekompresyon prosedürleri; klasik Whipple gibi rezeksiyon yöntemleri ya da Beger ve Frey gibi hibrit ameliyatlar olarak sınıflandırılır. Son yıllarda laparoskopik ve robotik yaklaşımlar daha kısa yatış süresi ve minimal invaziv avantajlar sunmaktadır. Uzun vadeli çalışmalar, özellikle erken dönemde uygulanan cerrahi prosedürlerin ağrı kontrolü ve yaşam kalitesini artırma yönünden endoskopik tedavilere kıyasla daha üstün sonuçlar verdiğini göstermektedir.
Chronic pancreatitis is a progressive and irreversible inflammatory disease of the pancreas characterized by exocrine and endocrine dysfunction, severe abdominal pain, steatorrhea, and Type 3 diabetes. While computed tomography, MRCP, and endoscopic ultrasonography are utilized for diagnosis, treatment strategies range from medical management to endoscopic interventions (ERCP/EUS), ESWL, and surgery. Depending on the morphological structure, surgical treatments are classified into decompression procedures like DuVal, Puestow-Gillesby, and the widely used Partington-Rochelle; resectional methods such as the classic Whipple; or hybrid operations like Beger and Frey. Recently, laparoscopic and robotic approaches offer minimal invasiveness with shorter hospital stays. Long-term studies indicate that surgical procedures, particularly when performed early, yield superior outcomes in pain management and quality of life compared to endoscopic therapies.
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