[Combined treatment of acute pancreatitis and its complications].
Results of combined treatment of 314 patients with acute pancreatitis, including 58 (15.1%) with pancreonecrosis were analyzed. Etiologic factors of acute pancreatitis were alcohol (59% patients), diseases of the bile ducts (31.5%), surgery (2.5%). Up-to-date diagnostic criteria of severe pancreatitis are presented, character of complications is analyzed. Treatment policy in acute edematous pancreatitis was conservative. In calculous cholecystitis cholecystectomy was performed after regress of acute pancreatitis. Fermentative ascitis-peritonitis was the indication for laparoscopy in aseptic phase of pancreonecrosis. US- and CT-guided puncture and drainage were often used. Surgeries were performed only for complications of pancreonecrosis, more often through mini-approaches. General lethality in acute pancreatitis was 1.9%, in pancreonecrosis - 10.7%, postoperative lethality in pancreonecrosis was 16.6%.
Blagovestnov
D A
DA
Khvatov
V B
VB
Upyrev
A V
AV
Grishin
G P
GP
Novosel
S N
SN
D000208:Acute Disease; D000328:Adult; D002764:Cholecystitis / Q000209:etiology / Q000401:mortality; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D010195:Pancreatitis / Q000150:complications / Q000188:drug therapy* / Q000601:surgery*; D019283:Pancreatitis, Acute Necrotizing / Q000150:complications / Q000188:drug therapy / Q000601:surgery; D010538:Peritonitis / Q000209:etiology / Q000401:mortality; D016896:Treatment Outcome