Minimally invasive treatment of acute pancreatitis, complicated by postnecrotic pancreatic pseudocysts and separated focuses of necrosis
DOI:
https://doi.org/10.24144/2415-8127.2018.58.36-40Keywords:
postnecrotic pancreatic pseudocyst, separated focus of necrosis, endoscopic drainage, catheter «pig tail».Abstract
Introduction. Acute necrotic pancreatitis (ANP) remains complicated problem of urgent surgery because of high frequency of systemic, purulent and septic complications, mortality rate, which is in patients with infected pancreonecrosis 14,7 – 26,4%. The aim of the study. The purpose of this study is to evaluate efficiency and establish indications for minimally invasive methods of treatment of postnecrotic pancreatic pseudocysts and separated focuses of necrosis. Materials and methods. For diagnostics were used ultrasonography, helical CT with contrast strengthening. Endoscopic interventions were applied by duodenoscopes ―Olympus‖ under control of X-ray machine ―Siemens BV 300‖. Cystodigestive fistulas were created by prickly papilotoms. For providing of long passability of cystodigestive fistula were used two endoprostheses like ―pig tail‖ sized 10 Fr with length 5 – 6 sm. For transpapillary drainage were used pancreatic endoprostheses like ―pig tail‖, sized 5 – 7 Fr with length 5 sm. Results and discussion. In 48 (51,6%) patients were applied minimally invasive methods of treatment. Percutaneous external drainage in 15 (31,2 %) patients, endoscopic transmural drainage of postnecrotic pseudocysts and combined endoscopic interventions in 33 (68,8%) patients. Conclusions. Usage of minimally invasive methods of treatment of acute necrotic pancreatitis complicated by postnecrotic pancreatic pseudocysts and separated focuses of necrosis help to improve results of treatment, reduction of complications amount, contraction of stationary treatment terms and improving of life quality.
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