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Khirurgii

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Year 2011 Vol. 19 No 6

GENERAL AND SPECIAL SURGERY

V.M. MAYOROV, Z.A. DUNDAROV, S.V. SVISTUNOV

EFFICACY ESTIMATION OF LOW-INVASIVE INTERVENTIONS IN ACUTE DESTRUCTIVE PANCREATITIS TREATMENT

Objectives. To perform the comparative analysis of efficiency of the low-invasive intervention technologies at various stages of the destructive forms of acute pancreatitis.
Methods. The surgical treatment results of 132 patients with the destructive forms of acute pancreatitis were analyzed. Depending on the destructive changes prevalance in the pancreas and the parapancreatic cellulose, open and low-invasive interventions were carried out.
Results. Laparoscopic sanitation and drainage of the abdominal cavity were the final method of treatment in the patients of the 1st group with the enzymatic peritonitis (36 patients). Puncture-drainage interventions were effective in the 2nd group (44 patients) on condition of liquid parapancreatic formations presence. In case of infected pancreatic necrosis forms when a pathological process was spreading on the retroperitoneal cellulose (the 3rd group) open drainage surgeries from the open laparotomic access appeared to be the most effective.
Conclusions. Efficiency of the low-invasive interventions application is determined by the morphological form of acute pancreatitis and destruction volume, both in the pancreas, and in the retroperitoneal cellulose. These interventions are the most effective at the intraabdominal exssudation and presence of the generated parapancreatic congestions of liquid while the septic secvestration of the retroparapancreatic cellulose is absent.

Keywords: acute destructive pancreatitis, ultrasound investigation, parapancreatitis, treatment tactics, low-invasive technologies, drainage of liquid parapancreatic formations
p. 45 – 50 of the original issue
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