Open AccessDiagnosis and treatment of destructive forms of acute pancreatitis
Author(s) -
В. В. Міщенко,
V. V. Grubnik,
P. I. Pustovoyt,
V. V. Horyachyy,
Valentyna Valentyna Velychko,
R. Yu. Vododyuk
Publication year - 2019
Publication title -
sučasnì medičnì tehnologìï
Language(s) - English
Resource type - Journals
ISSN - 2072-9367
DOI - 10.34287/mmt.2(41).2019.13
Subject(s) - medicine , acute pancreatitis , pancreatitis , perforation , peritonitis , sepsis , pancreas , intensive care medicine , surgery , radiology , materials science , punching , metallurgy
Purpose of the study. The study of thediagnosis and treatment of destructive formsof acute pancreatitis and the identification ofpossible ways to optimize them.Materials and methods. Destructive formsof acute pancreatitis were found in 16,8%.The algorithm for treating acute destructivepancreatitis consisted in artificial ventilationof the lungs, adequate infusion therapy,peridural anesthesia, setting up a nasoentericprobe, stimulating the bowels, correctinghemodynamics, intra- and extracorporaldetoxification, antisecretory, anti-bacterial,hepatoprotective, cerebroprotective, antioxidanttherapy, directed immune correction, use ofanti-enzyme drugs, suppression of the releaseof mediators inflammation, external secretoryactivity of the pancreas. Medical videolaparoscopy and puncture interventions underthe control of ultrasound were used as the firststage of surgical treatment. The indicationsfor traditional surgical interventions are largeareas of aseptic destruction, unlimited infectedpancreatic necrosis, infection of necrotic areaswith complete cell sequestration, abscesses withlarge sequesters, abdominal phlegmon, signsof progressive multiple organ failure and thedevelopment of arousal hemorrhage, perforationof cystic formations in the abdominal cavity,perforation of a hollow organ, purulentperitonitis.Results. The developed therapeutic tactics allowed, in destructive forms of acutepancreatitis, to achieve a reduction in overallmortality to 23,4%.Conclusion. Diagnostic and treatment tacticsfor destructive forms of acute pancreatitisshould be standardized depending on thetiming, severity of the disease, localization andprevalence of the destructive process, systemicand local complications.Keywords: acute, destructive, pancreatitis,diagnosis, treatment.