OPEN STENTING OF THE PANCREATIC DUCT AS A KEY TO UNDERSTANDING THE GENESIS OF CYSTIC-INFLAMMATORY TRANSFORMATION OF THE DUODENUM IN CHRONIC PANCREATITIS

Background. In the study, analyzing the genesis of duodenal passage disorders in chronic pancreatitis (CP), primarily cystic-inflammatory transformation (CIT) of the duodenum, a parallel is drawn with duodenostasis, which has a similar genesis of duodenal passage disorders. Purpose. Establishing the genesis of CIT of the duodenum, which has not yet been determined, allows to develop its pathogenetically justified surgical treatment and avoid the currently predominating extremely aggressive surgical approaches. Materials and methods. The key to understanding the genesis of CIT of the duodenum in CP was the results of open pancreatic duct stenting and follow-up observation of patients who underwent this procedure, as well as a study of the literature related to the surgery, anatomy, embryology, physiology, pathophysiology, and endocrinology of the pancreas and duodenum. Results. The principal result of this study is a hypothesis of the origin and development of CIT of the duodenum in CP and its pathogenetically justified surgical treatment based on this hypothesis. Conclusions. The conclusion of the study allows to avoid aggressive surgical treatment of CIT of the duodenum in favor of an organ-preserving approach significantly improving the results of surgical treatment for complicated forms of CP.