Acute Pancreatitis of Biliary Etiology. Report 2. Current Principles of Diagnosis and Treatment

Abstract

Principles of diagnostics and treatment based on the international proved practical recommendations are presented. The peculiarities of the pathogenesis of the disease dictate the necessity of distinguishing acute biliary pancreatitis into a separate clinical category and determine essential differences in its treatment tactics in comparison with acute pancreatitis of other etiology. The key components of the complex treatment of acute biliary pancreatitis are curing (conservative or operative) of duct hypertension and cholecystectomy, preferably – laparoscopic, and the time period, when duct system decompression can prevent the progression of acute pancreatitis, does not exceed 48 hours after the disease beginning. Early laparoscopic cholecystectomy is a pathogenetically grounded method of the final treatment of acute pancreatitis of biliary etiology. Laparoscopic cholecystectomy should be performed during current hospitalization irrespective of the disease severity in all patients as soon as their condition allows to survive the intervention.