Purpose of the study. The study of the
diagnosis and treatment of destructive forms
of acute pancreatitis and the identification of
possible ways to optimize them.
Materials and methods. Destructive forms
of acute pancreatitis were found in 16,8%.
The algorithm for treating acute destructive
pancreatitis consisted in artificial ventilation
of the lungs, adequate infusion therapy,
peridural anesthesia, setting up a nasoenteric
probe, stimulating the bowels, correcting
hemodynamics, intra- and extracorporal
detoxification, antisecretory, anti-bacterial,
hepatoprotective, cerebroprotective, antioxidant
therapy, directed immune correction, use of
anti-enzyme drugs, suppression of the release
of mediators inflammation, external secretory
activity of the pancreas. Medical video
laparoscopy and puncture interventions under
the control of ultrasound were used as the first
stage of surgical treatment. The indications
for traditional surgical interventions are large
areas of aseptic destruction, unlimited infected
pancreatic necrosis, infection of necrotic areas
with complete cell sequestration, abscesses with
large sequesters, abdominal phlegmon, signs
of progressive multiple organ failure and the
development of arousal hemorrhage, perforation
of cystic formations in the abdominal cavity,
perforation of a hollow organ, purulent
peritonitis.
Results. The developed therapeutic tactics allowed, in destructive forms of acute
pancreatitis, to achieve a reduction in overall
mortality to 23,4%.
Conclusion. Diagnostic and treatment tactics
for destructive forms of acute pancreatitis
should be standardized depending on the
timing, severity of the disease, localization and
prevalence of the destructive process, systemic
and local complications.
Keywords: acute, destructive, pancreatitis,
diagnosis, treatment.
