The role of laparoscopy in the diagnosis and treatment of pancreonecrosis

Abstract

Background: Wide implementation of endovideosurgery in different phases of acute pancreatitis (AP) can significantly lower toxicity and in most cases in combination with complex conservative therapy to stop the pathological process Methods: During the period 2011-2015 in RRCEM researching shows hospitalized with a diagnosis of AP in 1654 patients treated conservatively in 1112 (67.2%), 357 (21.6%) operated have been applied including laparoscopic methods 185 (34.1%). Results: At the same time in 39 (21.1%) revealed edematous form fat focal pancreatic verified in 97 (52.4%) and hemorrhagic necrotizing pancreatitis in 49 (26.5%). These caused following laparoscopic procedures: laparoscopic sanitation stuffing bags with drainage of the abdominal cavity - 35 (18.9%); laparoscopic cholecystectomy sanitation drainage of omental and abdominal cavity - 68 (36.7%); laparoscopic cholecystectomy common bile duct drainage by Pikovsky sanitation drainage of omental and abdominal cavity - 82 (44.3%). Conclusion: In patients with acute destructive pancreatitis in the absence of complications of pancreatic necrosis extraorganic retroperitoneal laparoscopic procedures is a valuable alternative for the traditional operations and reduces the incidence of postoperative complications from 35.4% to 18.5%, and mortality from 13.4% to 7.4% herewith the necessity of re-intervention occurs only in 4.3% of cases in the total population increases the effectiveness of therapeutic laparoscopy to 88.9%