Treatment Strategy of Acute Pancreatitis Depending on the Degree of Pancreas Damage in General Surgery Unit

Abstract

Acute pancreatitis (AP) still remains an urgent problem of emergency abdominal surgery. In severe forms of this disease, there are a lot of complications, that lead to high mortality rate. There are many, often conflicting, opinions about surgical approach to AP. That is why, it’s important to find the optimal algorithm for AP treatment. The purpose of the study: to analyze the surgical approach to AP treatment in general surgery unit depending on the severity of AP and the extent of pancreatic damage. Material and methods: We performed a retrospective analysis of 347 case reports of the patients of Grodno City Clinical Hospital №4 with regard to the surgical approach used for the established diagnosis of AP. Results. Conservative treatment was the final strategy in 291 cases (83.86%). Minimally invasive interventions were effective in 37 out of 56 patients (66.07%); mortality at this stage was 1 patient (1.79%). There were open, mostly programmed interventions in the last stage of AP. They were performed in 19 patients, of these 4 patients (21.05%) died. Conclusions. The step-up approach (conservative treatment – minimally invasive interventions – open surgical interventions) permitted to reduce the number of open operations, as well as the overall mortality rate in the analyzed group.