Surgical Treatment of Patients with Destructive Forms of Acute Pancreatitis

Abstract

One of the current hot topics in surgery is pancreatic diseases, namely acute pancreatitis. The aim of the study: to improve the results of treatment of patients with destructive forms of acute pancreatitis by means of early diagnostics, rehabilitation and minimally invasive surgery. Material and methods. The paper presents the results of treatment of 167 (100%) patients with destructive forms of acute pancreatitis. The patients were treated according to the developed method of conservative and improved method of surgical treatment. The method was based on longitudinal decapsulation of the pancreas, low-traumaticity, minilaparotomy, full visual control, one-stage sanation and drainage of the omental sac and abdominal cavity. The results were evaluated according to clinical parameters, omentobursostomy status and postoperative complications. Results. The analysis of clinical observations showed that good treatment results were achieved with full-fledged conservative treatment aimed at stabilising the condition and bringing the patient out of multi-organ failure. In the early postoperative period due to the danger of damage to the hollow organs we found another approach and did not perform severe ligations that could cause arterial bleeding, duodenal and colonic fistulas, but simply washed the omentobursostomy with furacilin solution under pressure and waited for independent rejection of sequestrations. In the immediate postoperative period complications occurred in 13 (7.8%) patients. The average bed-day was 10.8±0.4. The lethal outcome was in 5 cases. Conclusion. The study revealed that early diagnosis, timely surgical intervention according to improved surgical treatment tactics reduced complication rates, mortality and increased quality of life indicators.