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Summary. Objective — increasing the efficiency of diagnosis and treatment in patients with destructive forms of pancreatitis. Materials and methods. 89 patients with acute destructive pancreatitis were examined. There were 37 men (41,5 %), 52 women (58,4 %). The average age of patients ranged from 28 to 64 years. In order to objectively assess the severity of the inflammatory process in the pancreas and surrounding tissues, organs of the abdominal cavity, clinical and biochemical studies were used, as well as high-tech methods such as ultrasound examination with dopplerometry, computed tomography. Results. According to ultrasound, the edematous form of acute pancreatitis was diagnosed in 22 (27,4 %) patients during the examination, fatty pancreatic necrosis was diagnosed in 19 (21,3 %) patients. Hemorrhagic pancreatic necrosis was found in 31 (34,8 %) patients, mixed in 17 (19,1 %) patients. The study revealed the main etiological factors of the disease, while in 63 (70,8 %) patients the cause of acute pancreatitis was biliary pathology, alcohol etiology occurred in 17 (19,1 %) patients, and 9 (10,1 %)) - she had a post-traumatic character. Computed tomography was performed in cases of doubt in the data of ultrasound examination, especially in patients with overweight, and for the purpose of differential diagnosis in 23 (25,8 %) patients. Conclusions. Acute destructive forms of pancreatitis have a polymorphic echography picture. Ultrasound diagnostics and computed tomography should be mandatory elements of the diagnostic algorithm for various forms of acute destructive pancreatitis. The diagnostic accuracy of these non-invasive methods in verification of acute destructive pancreatitis and its complications as a whole was 92,8 %. A decrease in the level of postoperative complications and mortality associated with a decrease in the progression of pancreatic necrosis because of suppression of pancreatic secretion.

Background: High mortality because of various infectious complications (immediate cause in 42.5 % of cases), the ever-increasing frequency of purulent inflammatory diseases, as well as the growth of microbial resistance to anti-bacterial drugs, force to seek a solution to the problem among local antiseptics. Aim: to compare the effectiveness of antiseptics DECASAN Yuria-Pharm and CUTASEPT G in the treatment of puru-lent inflammatory diseases of different localization.Materials and methods: The study involved 30 patients with purulent inflammatory diseases of various localiza-tions. Patients were divided into two groups, according to the chosen tactics of local antiseptic therapy, in patients of the first study group (n = 15; mean age – 49.73 ± 6.35 years) antiseptic treatment was performed with a drug based on 0.02 % decamethoxine (Decasan). In the second group (n = 15; mean age – 51.4 ± 5.14 years) treatment was performed with a disinfectant (skin antiseptic) “Cutasept G”. Collection of material for microbiological examination (bacteriological culture) was performed before treatment, 3 and 5 days after treatment. Probability analysis was performed according to Student’s t-test. A statistically significant difference between the indicators was considered when the probability of validity of the null hypothesis was less than 5 % (p <0.05).Results: Analyzing the results of bacteriological examination of both groups, in the first, where Decasan was used and in the second, with the use of Cutasept G, it was found that at the beginning of treatment there was a pronounced microbial colonization of wounds, not significantly different among patients in both groups (p <0.05). Microbio-logical observation of the course of purulent-inflammatory process in the dynamics showed a significantly slowed down process of microbial purification in the second group (Cutasept G), the condition for 5 days was lg (8.8 ± 0.4) CFU/ml. At that time for patients of the first comparison group the number of microorganisms in 1 ml of wound contents, expressed in lg, was (4.8 ± 0.4) CFU/ml, which does not exceed the critical level. The obtained values were significantly higher than with Cutasept G (p <0.05), which was twice higher than the level of microbial colonization compared to the treatment of wounds with 0.02 % decamethoxine solution (p <0.001).Conclusions: The use of antiseptic 0.02 % decamethoxine for 5 days provides a reduction in the number of oppor-tunistic pathogens lg (4.8 ± 0.4) CFU/ml, which is 1.9 times lower (p <0.05) compared with the use of Cutasept G, creating conditions for the settlement of normal microbiotic skin (Corynebacterium spp., S. epidermidis). Antiseptic Dekasan is characterized by good healing properties due to its high antimicrobial activity, isotonicity, which makes it possible to use it successfully in patients with purulent inflammatory diseases of various localizations. In addition, the use of Dekasan promotes rapid cleansing of wounds from purulent-necrotic contents and formation of granula-tion tissue in them.

Представлены результаты лечения больных по поводу острых язв желудка и двенадцатиперстной кишки (ДПК), осложненных кровотечением, возникших после операций на органах гепатопанкреатобилиарной зоны. Внедрение разработанной индивидуализированной тактики лечения пациентов с активным использованием современных методов эндогемостаза позволило улучшить его результаты.

Ключевые слова: опухоли малого таза, эвисцерации, посиндромный подход, комбинированные операции Ключові слова: пухлини малого тазу, евісцерації, посиндромний підхід, комбіновані операції