Ways to standardize and coding change in the area of ​​major duodenal papilla in acute biliary pancreatitis ACCORDING duodenoscopy

摘要

FIELD: medicine.;SUBSTANCE: invention relates to medicine, namely to abdominal surgery, endoscopy and can be used for determination of indications for urgent endoscopic papillosphincterotomy. Examination of changes of major duodenal papilla zone in case of acute biliary pancreatitis is carried out by means of duodenoscopy. Examines and designated as descriptors P, B and F are degree of changes of major duodenal papilla zone (P), amount of bile in duodenum (B), dimensions of intraduodenal part of common bile duct - longitudinal fold (F). Abbreviation PBF is included into clinical diagnosis, estimating absence of changes of major duodenal papilla as (P₁) as 1 point, inflammation of major duodenal papilla - edema, hyperemia (P₂) as 2 points, bulging of major duodenal papilla (P₃) as 3 points, presence of wedged stone (P₄) as 4 points, estimating considering amount of bile in duodenum as (B₁) as 1 point, small amount of bile as (B₂) as 2 points, bile traces (B₃) as 3 points, absence of bile (B₄) as 4 points, and estimating intraduodenal part of common bile duct - longitudinal fold 4 mm long or shorter as (F₁) as 1 point, intraduodenal part of common bile duct - longitudinal fold 5 mm long or longer (F₂) as 2 points, expressed longitudinal fold with edema or tension (F₃) as 3 points, then points of descriptors are added and if value equals 7 and more absolute indication for urgent endoscopic papillosphincterotomy is determined, if sum of points is 5 or 6 indications for endoscopic papillosphincterotomy is relative, and if sum of points is equal 4 and less endoscopic papillosphincterotomy is not indicated.;EFFECT: method allows to specify clinical diagnosis and determine indications for performing urgent endoscopic papillosphincterotomy.;2 ex