Early diagnosis and surgical tactics at acute destructive pancreatitis

摘要

Based on retrospective analysis of 292 case histories of patients with acute pancreatitis the computed model permitted to differentiate destructive and hydropic pancreatitis and to predict clinical course of pancreonecrosis has been constructed. Algorithm of treatment tactics depending on this analysis has been developed. Use of laparoscopy in early period with results of computed prognosis permitted to decrease the rate of diagnostic mistakes at pancreonecrosis from 59.2 to 39.5%. Algorithm of surgical tactics permitted to reduce lethality at small- and medium-focal pancreonecrosis from 51.7 to 5.1%, and the rate of purulent complication--from 23.8 to 2.5%.