[The indices of Morbidity and Mortality of acute pancreatitis as indicator of medical care condition on regional level].

The high digital incidence rates of acute pancreatitis world-wide and the death rates from its destructive forms explain the great interest to this problem. Among diseases of gastrointestinal tract, this pathology is characterized by variety of clinical manifestations, frequent severe complications, difficult choice of proper tactics of treatment and severe prognosis of development of disease. The gallstone disease, alcohol abuse are among most common causes of development of disease. However, it is important to study statistical indices of prevalence and mortality of acute pancreatitis at the regional level. The purpose of study was to analyze incidence and mortality of acute pancreatitis in 2010-2018. The indices were analyzed in the region as a whole and as well as in the Medical Districts of the Republic of Bashkortostan. The incidence of acute pancreatitis had period of acute upraise in 2010 (86.5) and 2018 (76.6). At the same time, mortality since 2011 (4.7) was characterized by slight increasing and up to 2018 it almost doubled (8.1). The overall picture demonstrates increasing of mentioned indices in the region. In case of acute pancreatitis, mortality increased from 7.4 in 2010 to 10.5 in 2018. It can be explained by increasing incidence of destructive forms of disease, when severe and sometimes fatal complications often develop. In the republic nine medical districts were organized making possible to judge more clearly the change in morbidity and mortality depending on the territorial affiliation. The analysis of these statistical indices for medical districts demonstrated objectivity of assessing state of medical care. In particular districts (Birsk, Neftekamsk), timely retrospective assessment of morbidity and mortality rates of acute pancreatitis and the comprehensive measures resulted in their stabilization and even decreasing. A clear record of medical records, considering all sick and dead from acute pancreatitis, helps to improve organizational, preventive and therapeutic measures.

[Comparative analysis of the scores of severity of acute pancreatitis].

Based on an analysis of case histories of 45 patients with destructive pancreatitis and coexisting peritonitis the authors have proposed a score assessment of the disease severity. It is based on accounting the morphological alterations in the pancreas and retroperitoneal fat, statistical data from case histories of the patients. This method of assessing the severity of acute pancreatitis is good for specification of the management of the patient in the hospital and for a retrospective analysis of the case history.

[The ways of purulent spread in necrotizing pancreatitis].

Results of examination of 206 patients with destructive pancreatitis are presented. On the basis of complex research it has been allocated five most significant variants of distribution of purulent process to retroperitoneal space. Existence of correlation of morphological changes in pancreas and retroperitoneal cellular tissue has been shown. Contrast ductography allowed to identify more precisely a place of defect in a wall of a duct and to predict the ways of purulent spread in retroperitoneal space. In view of it surgical tactics allows to improve results of treatment.