Year 2020 Vol. 28 No 2

REVIEWS

N.M. GREKOVA 1 , N.B. SHISHMENCEV 2, Y.V. NAIMUSHINA 2, A.G. BUHVALOV 3

ACUTE PANCREATITIS: MODERN CONCEPTS OF SURGICAL TREATMENT

South Ural State Medical University 1,
Chelyabinsk Railway Clinical Hospital 2, Chelyabinsk,
Central Health Care Unit No15 3, Snezhinsk,
The Russian Federation

The literature review over the past 15 years presents a modern approach to acute pancreatitis and its complications. An up-to-date international classification system for acute pancreatitis, adopted in Atlanta (USA) in 1992 and revised in 2012 (3rd revision) is given. The current principles and trends in the treatment of moderate-to-severe acute pancreatitis and severe acute pancreatitis are reviewed. Particular attention is paid to the integrated, multidisciplinary approach in the diagnosis and surgical treatment planning in acute severe necrotizing pancreatitis and its complications. Algorithms of a modern staged treatment of acute severe pancreatitis, depending on the cause of the disease, on the phases and periods of the disease, the severity of a patients condition, and prevalence of the pathological process are presented. Various approaches to the management of patients with the infected pancreatic necrosis, including minimally invasive technologies are analyzed. The maximal effectiveness of the acute severe pancreatitis surgical treatment is provided by a step-by-step strategy that depends on the etiology of the disease. The combination or alternation of minimally invasive puncture-draining interventions with open surgery and retroperitoneoscopy provided all necessary equipment is the most rational.

Keywords: acute pancreatitis, necrotizing pancreatitis, infected necrotizing pancreatitis, unlimited infected retroperitoneal necrosis, retroperitoneoscopy, minimally invasive interventions, percutaneous drainage
p. 197-206 of the original issue
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Address for correspondence:
454092, Russian Federation,
Chelyabinsk, Vorovsky Str., 64,
South Ural State Medical University,
Faculty Surgery Department.
Tel. +7 351 902 83 46,
e-mail: grekovanm@mail.ru,
Natalia M Grekova
Information about the authors:
Grekova Natalia M., PhD, Associate Professor of the Faculty Surgery Department, South Ural State Medical University, Chelyabinsk, Russian Federation.
https://orcid.org/0000-0002-3364-7201
Shishmentsev Nikolay B., Surgeon, the Purulent Surgery Department, Chelyabinsk Railway Clinical Hospital, Chelyabinsk, Russian Federation.
https://orcid.org/0000-0003-0997-3442
Naimushina Yuliana V., PhD, Associate Professor of the Faculty Surgery Department, South Ural State Medical University, Chelyabinsk, Russian Federation.
https://orcid.org/0000-0002-6032-3501
Buhvalov Andrey G., MD, Surgeon, the Surgical Unit, Central Health Care Unit No15 of Federal Biomedical Agency, Snezhinsk, Russian Federation.
https://orcid.org/0000-0002-9428-6972
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