RESUMEN
The results of treatment of 345 patients, operated on for an acute nonbiliary aseptic necrotic pancreatitis, are adduced. There was established, that rejection to perform an early open access operations with simultaneous application of modern miniinvasive procedures for peritonitis of the enzyme origin (laparoscopy, laparocentesis), an acute aseptic accumulations of liquid in bursa omentalis and cellular tissue of retroperitoneal space, pancreatic pseudocysts (puncture-drainage interventions under ultrasonographic guidance) and as well as direct operative interventions on pancreatic gland and cellular tissue of retroperitoneal space, using extraperitoneal miniaccesses in presence of sequesters, have permitted to lower postoperative lethality from 15.2 to 4.1%, and to secure a purulent-septic complications prophylaxis in 93.2% of patients. Application of the puncture-drainage interventions under ultrasonographic control, as well as lumbotomy and sequestrectomy, in the environment of aseptic inflammation, have permitted to escape purulent complications occurrence while an acute aseptic accumulations of liquid are present in bursa omentalis in 96.1% of patients and in cellular tissue of retroperitoneal space--in 69.6%.
Asunto(s)
Procedimientos Quirúrgicos Mínimamente Invasivos/métodos , Pancreatectomía/métodos , Pancreatitis Aguda Necrotizante/cirugía , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pancreatitis Aguda Necrotizante/diagnóstico , Pancreatitis Aguda Necrotizante/etiología , Pancreatitis Aguda Necrotizante/mortalidad , Complicaciones Posoperatorias/mortalidad , Complicaciones Posoperatorias/prevención & control , Índice de Severidad de la Enfermedad , Resultado del Tratamiento , Adulto JovenAsunto(s)
Pancreatectomía/métodos , Pancreatitis/diagnóstico por imagen , Pancreatitis/cirugía , Enfermedad Aguda , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , Procedimientos Quirúrgicos Mínimamente Invasivos , Índice de Severidad de la Enfermedad , Resultado del Tratamiento , Ultrasonografía Doppler en Color , Adulto JovenRESUMEN
The results of observation on 426 patients were analyzed, in whom the acute pancreatitis form, the kind of complication and duration of ultrasonographic monitoring conduction were determined using ultrasonographic investigation. In 82 patients miniinvasive treatment of hollow organs under ultrasonographic control was performed. The complications were absent, all the patients are alive.