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Surgical treatment of an acute non-biliary aseptic necrotizing pancreatitis
Authors:Kondratenko P G  Kon'kova M V  Dzhansyz I N
Abstract:
The results of treatment of 345 patients, operated on for an acute nonbiliary aseptic necrotic pancreatitis, are adduced. There was established, that rejection to perform an early open access operations with simultaneous application of modern miniinvasive procedures for peritonitis of the enzyme origin (laparoscopy, laparocentesis), an acute aseptic accumulations of liquid in bursa omentalis and cellular tissue of retroperitoneal space, pancreatic pseudocysts (puncture-drainage interventions under ultrasonographic guidance) and as well as direct operative interventions on pancreatic gland and cellular tissue of retroperitoneal space, using extraperitoneal miniaccesses in presence of sequesters, have permitted to lower postoperative lethality from 15.2 to 4.1%, and to secure a purulent-septic complications prophylaxis in 93.2% of patients. Application of the puncture-drainage interventions under ultrasonographic control, as well as lumbotomy and sequestrectomy, in the environment of aseptic inflammation, have permitted to escape purulent complications occurrence while an acute aseptic accumulations of liquid are present in bursa omentalis in 96.1% of patients and in cellular tissue of retroperitoneal space--in 69.6%.
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