[Diagnosis and treatment of sterile pancreonecrosis].
The experience in the treatment of 77 patients with sterile pancreonecrosis is analyzed. The importance of USE as an effective method of screening-diagnosis is emphasized. Computed tomography provides a more accurate diagnosis of pancreonecrosis and complications of it. Lethality in pancreonecrosis correlates with necrosis severity. More than 50% necrosis-affected parenchyma in combination with three and more systemic complications is an unfavorable prognostic factor. Hemofiltration and early management with carbapenem antibiotics arrest progression of multiorgan failure and pyoseptic complications in 75% of cases. Laparoscopic sanation of the abdominal cavity is necessary only for patients with peritonitis. This procedure may be supplemented with laparoscopic cholecystectomy and endoscopic papillosphincterotomy with lithoextraction directly during sanation.
Brekhov
E I
EI
Reshetnikov
E A
EA
Mironov
A S
AS
Denisov
A Iu
AIu
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017081:Cholecystectomy, Laparoscopic / Q000379:methods*; D005260:Female; D006801:Humans; D053583:Interleukin-1beta / Q000276:immunology; D007376:Interleukin-2 / Q000276:immunology; D015850:Interleukin-6 / Q000276:immunology; D008297:Male; D008875:Middle Aged; D019283:Pancreatitis, Acute Necrotizing / Q000175:diagnosis* / Q000276:immunology / Q000601:surgery*; D014409:Tumor Necrosis Factor-alpha / Q000276:immunology
D053583:Interleukin-1beta; D007376:Interleukin-2; D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha