EARLY RHEOLOGICAL DRUG THERAPY AND STIMULATION OF DELIMITING PROCESSES IN PATIENTS SUFFERING FROM ACUTE PANCREATITIS

The results of surgical treatment of 470 patients with acute pancreatitis of severe severity were studied. Out of 314 patients with infected pancreatonecrosis, 224 had retroperitoneal phlegmon and 90 - parapancreal abscesses. In this group of patients, early surgical treatment was used in the first...

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Autores principales:	V. G. Lubyansky, A. N. Zharikov
Formato:	article
Lenguaje:	RU
Publicado:	Scientific Сentre for Family Health and Human Reproduction Problems 2017
Materias:	acute pancreatitis pancreatic necrosis retroperitoneal fiber delimiting tissular barrier minimally invasive technologies local rheological therapy Science Q
Acceso en línea:	https://doaj.org/article/451d012b7cd443138539f6cd0ebfc322
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spelling	oai:doaj.org-article:451d012b7cd443138539f6cd0ebfc3222021-11-23T06:14:39ZEARLY RHEOLOGICAL DRUG THERAPY AND STIMULATION OF DELIMITING PROCESSES IN PATIENTS SUFFERING FROM ACUTE PANCREATITIS2541-94202587-959610.12737/article_5a0a7e2b773db4.76486922https://doaj.org/article/451d012b7cd443138539f6cd0ebfc3222017-11-01T00:00:00Zhttps://www.actabiomedica.ru/jour/article/view/461https://doaj.org/toc/2541-9420https://doaj.org/toc/2587-9596The results of surgical treatment of 470 patients with acute pancreatitis of severe severity were studied. Out of 314 patients with infected pancreatonecrosis, 224 had retroperitoneal phlegmon and 90 - parapancreal abscesses. In this group of patients, early surgical treatment was used in the first 3-5 days from the time of admission. In all cases in the process of laparotomy open necrectomy and drainage were performed. In 156 patients of the second group, a savings technology was used for 4-8 weeks, aimed at distinguishing the purulent-necrotic process. Of these, 98 had local intra-arterial rheological therapy, 46 had early video laparoscopic drainage, and 12 had decompression retroperitoneal drainage. As soon as the delimitation (formation of the fluid cluster, parapancreatic cyst, abscess) was achieved, in 4-6 weeks in this group, minimally invasive transabdominal or transgastral drainage was performed and only open operations "on demand" were carried out with the progression of the purulent-necrotic process. The results of the treatment showed high mortality in the early extended operations in the first group of patients. With retroperitoneal phlegmon it reached 55.4 %. Savings tactics aimed at limiting the process in the retroperitoneal tissue and subsequent minimally invasive drainage, was characterized by a lower mortality - 31 (19.9 %) patient. Early video laparoscopic drainage of the abdominal cavity and retroperitoneal space (mortality - 10.9 %) and local rheological drug therapy (mortality - 21.4 %) were the most effective among the minimally invasive technologies of surgical treatment of pancreonecrosis, which facilitated the accelerated formation of the delimitation of the inflammatory process in the pancreas and retroperitoneal space.V. G. LubyanskyA. N. ZharikovScientific Сentre for Family Health and Human Reproduction Problemsarticleacute pancreatitispancreatic necrosisretroperitoneal fiberdelimiting tissular barrierminimally invasive technologieslocal rheological therapyScienceQRUActa Biomedica Scientifica, Vol 2, Iss 6, Pp 9-16 (2017)
institution	DOAJ
collection	DOAJ
language	RU
topic	acute pancreatitis pancreatic necrosis retroperitoneal fiber delimiting tissular barrier minimally invasive technologies local rheological therapy Science Q
spellingShingle	acute pancreatitis pancreatic necrosis retroperitoneal fiber delimiting tissular barrier minimally invasive technologies local rheological therapy Science Q V. G. Lubyansky A. N. Zharikov EARLY RHEOLOGICAL DRUG THERAPY AND STIMULATION OF DELIMITING PROCESSES IN PATIENTS SUFFERING FROM ACUTE PANCREATITIS
description	The results of surgical treatment of 470 patients with acute pancreatitis of severe severity were studied. Out of 314 patients with infected pancreatonecrosis, 224 had retroperitoneal phlegmon and 90 - parapancreal abscesses. In this group of patients, early surgical treatment was used in the first 3-5 days from the time of admission. In all cases in the process of laparotomy open necrectomy and drainage were performed. In 156 patients of the second group, a savings technology was used for 4-8 weeks, aimed at distinguishing the purulent-necrotic process. Of these, 98 had local intra-arterial rheological therapy, 46 had early video laparoscopic drainage, and 12 had decompression retroperitoneal drainage. As soon as the delimitation (formation of the fluid cluster, parapancreatic cyst, abscess) was achieved, in 4-6 weeks in this group, minimally invasive transabdominal or transgastral drainage was performed and only open operations "on demand" were carried out with the progression of the purulent-necrotic process. The results of the treatment showed high mortality in the early extended operations in the first group of patients. With retroperitoneal phlegmon it reached 55.4 %. Savings tactics aimed at limiting the process in the retroperitoneal tissue and subsequent minimally invasive drainage, was characterized by a lower mortality - 31 (19.9 %) patient. Early video laparoscopic drainage of the abdominal cavity and retroperitoneal space (mortality - 10.9 %) and local rheological drug therapy (mortality - 21.4 %) were the most effective among the minimally invasive technologies of surgical treatment of pancreonecrosis, which facilitated the accelerated formation of the delimitation of the inflammatory process in the pancreas and retroperitoneal space.
format	article
author	V. G. Lubyansky A. N. Zharikov
author_facet	V. G. Lubyansky A. N. Zharikov
author_sort	V. G. Lubyansky
title	EARLY RHEOLOGICAL DRUG THERAPY AND STIMULATION OF DELIMITING PROCESSES IN PATIENTS SUFFERING FROM ACUTE PANCREATITIS
title_short	EARLY RHEOLOGICAL DRUG THERAPY AND STIMULATION OF DELIMITING PROCESSES IN PATIENTS SUFFERING FROM ACUTE PANCREATITIS
title_full	EARLY RHEOLOGICAL DRUG THERAPY AND STIMULATION OF DELIMITING PROCESSES IN PATIENTS SUFFERING FROM ACUTE PANCREATITIS
title_fullStr	EARLY RHEOLOGICAL DRUG THERAPY AND STIMULATION OF DELIMITING PROCESSES IN PATIENTS SUFFERING FROM ACUTE PANCREATITIS
title_full_unstemmed	EARLY RHEOLOGICAL DRUG THERAPY AND STIMULATION OF DELIMITING PROCESSES IN PATIENTS SUFFERING FROM ACUTE PANCREATITIS
title_sort	early rheological drug therapy and stimulation of delimiting processes in patients suffering from acute pancreatitis
publisher	Scientific Сentre for Family Health and Human Reproduction Problems
publishDate	2017
url	https://doaj.org/article/451d012b7cd443138539f6cd0ebfc322
work_keys_str_mv	AT vglubyansky earlyrheologicaldrugtherapyandstimulationofdelimitingprocessesinpatientssufferingfromacutepancreatitis AT anzharikov earlyrheologicaldrugtherapyandstimulationofdelimitingprocessesinpatientssufferingfromacutepancreatitis
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EARLY RHEOLOGICAL DRUG THERAPY AND STIMULATION OF DELIMITING PROCESSES IN PATIENTS SUFFERING FROM ACUTE PANCREATITIS

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