Optimization of Diagnostics and Treatment of Destructive Forms of Acute Pancreatitis

Abstract

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.

Stages of Morphological Changes of Target Organs in Experimentally Simulated Acute Peritonitis

“…Незважаючи на прогрес у діагностиці, розвитку інструментальних обстежень, методів хірургічного та післяопераційного лікування летальність залишається на доволі високому рівні [1][2][3][4][5], що спонукає до оптимізації та покращення вже існуючих та розробки нових методів і принципів лікування [6][7][8]. В умовах сьогодення основним принципом лікування хворих на гострий перитоніт (ГП) є мульти-дисциплінарний підхід.…”