The evolution of surgical treatment of acute destructive pancreatitis

Abstract

This paper gives a brief overview of the problem of choosing the optimal treatment of acute destructive pancreatitis. At the Department of Surgery SBEI CPE KSMA, a comparative analysis of different surgical treatment of acute pancreatitis was carried out at different times. During the first period (1987-1993), 102 patients were operated, with adherence to the active surgical tactics. Operations were carried out mainly in the first week of the onset of the disease, i.e. in an aseptic stage, including 27 patients (26.5%) undergoing corpora-caudal pancreatectomy and splenectomy. Postoperative mortality in this case was 37.2%. During the second stage (1994-2000), 256 patients were operated. All operations included drainage and were carried out on different dates after the onset. Postoperative mortality was 17.3%.Since 2002, the clinic has been adhered to noninvasive therapeutic approach, when the alternative to the "early" surgical interventions is therapeutic manipulations under ultrasound or laparoscopic guidance, which reduced the overall postoperative mortality rate up to 13.4%. The mortality rate in moderate pancreatic necrosis has been reduced up to 5%, and in its severe forms - up to 26%.