[The combined treatment of acute destructive pancreatitis]

Extensive resection of the pancreas is shown to be accompanied by a high case-fatality rate and unsatisfactory late results such as formation of postpancreatectomy syndrome. Expediency is proved of employment of conservative treatment (pancreatic secretion blockers, antioxidants, antibiotics, different kinds of extracorporal and intracorporal detoxication etc.). Indications to operative treatment of destructive pancreatitis are determined, which include progressive polyorgan incompetence that does not respond to adequate intensive therapy for 48 to 72 hours, progression of biliary pancreatitis (surgery is performed during the first 24-hour period), infected necroses (at day 15 to 17). The above treatment option was associated with a decline in the general case mortality down to 6.15% and in the postoperative mortality down to 15%.