Minimally invasive technologies in diagnosis and treatment of local purulent complications of destructive pancreatitis

摘要

Sixty patients with local purulent complications of destructive pancreatitis were treated. Interventional procedures under visual control were performed in 38 patients: in 26 (68.4%) -- under control of computed tomography and in 12 (31.6%) -- ultrasound-assisted procedures. Traditional surgeries were performed in 22 patients. Complete recovery was seen in 23 (60,6%) of 38 patients of the first group, all these patients have solitary, one-chamber and non-sequestered purulent cavities which are formed in 82.6% cases due to microfocal pancreonecrosis. Transcutaneous drainage was ineffective in 14 (36.8%) patients that required conversion to laparotomy. It is demonstrated that treatment policy in purulent-necrotic complication of pancreonecrosis must be individual. Adequate method of local treatment must be determined by size and localization of purulent and necrotic lesions, presence of sequesters and septa.