Diagnosis and treatment tactics acute pancreatitis

Abstract

Aim. Improving the immediate results of the treatment of patients with acute pancreatitis.Material and methods. We studied the results of diagnosis and treatment of 126 patients diagnosed with acute pancreatitis. In our observation, the main causes of acute pancreatitis in 92 (73.0%) patients were cholelithiasis (biliary genesis), in 25 (19.8%) patients, acute pancreatitis (AP) had an alcoholic genesis, in 4 (3.2%) cases, pancreatitis occurred as a result of duodenal ulcer penetration into the head of the gland, and in 5 (4.0%) cases, АР had a traumatic genesis.Results. In 38 observed patients, extracorporeal detoxification methods were used in complex treatment, in addition, hemofiltration was used in 17.0% of cases, plasmapheresis was performed in 71.0% of patients, and peritoneal dialysis was performed in combination with plasmapheresis in 12.0% of cases. Minimally invasive methods of treatment were performed in 27 (21.4%) patients with acute pancreatitis.In 17 patients, we performed percutaneous drainage interventions with ultrasound navigation. Surgical interventions were performed in 36 (28.6%) patients with acute pancreatitis. Of these, 9 (7.1%) patients were operated on within 5 days, 21 (16.7%) patients were operated on within 14 days, the remaining 6 (4.8%) patients were operated on within 24 to 14days. 30 days.Against the background of the use of a complex differentiated individual approach in the patients we observed with destructive forms of AP, the incidence of fatal cases was 9.5% (n=12), which were due to the development of progressive multiple organ failure.Conclusion. The main tasks in the treatment of patients with acute pancreatitis should be the urgent elimination of etiopathogenetic factors in the development of this pathology, the timely appointment of intensive therapy with the implementation of minimally invasive surgical interventions.