Проблема выбора лечебной тактики при тяжелом остром панкреатите

Аннотация

Aim. Improvement the effectiveness of treatment of patients with severe acute pancreatitis. Materials and methods. The experience of treatment of 87 patients with severe acute pancreatitis is considered. The protocol of therapeutic and diagnostic tactics included active conservative management of patients with a daily overall assessment of the clinical picture according to the Marshal, APACHE II and Ranson scales, the dynamics of laboratory changes, combined with the analysis of instrumental research data (US, CT and MRI), the use of delayed surgical interventions. Results. In 54 (62%) patients, the therapy led to recovery without surgical treatment, 33 (38%) were operated for purulent-septic complications. The overall mortality in the study group was 18.4%. Satisfactory outcomes were achieved in 71 patients (81.6%). Mortality among operated patients was 48.5%. Conclusion. The use of the developed protocol led to a decrease in overall and postoperative mortality, the number of systemic complications and a significant increase in survival in severe acute pancreatitis.