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Published on: March 15, 2024
[Improvement of acute destructive pancreatitis management]
I S Malkov1,2, A M Zainutdinov1, I I Khamzin2
1Kazan State Medical Academy - branch of the Russian Medical Academy for Continuing Professional Education, Kazan, Russia.
Objective:
To reduce the incidence of complications in acute destructive pancreatitis via stenting of the main pancreatic duct in complex treatment of these patients.
Material And Methods:
There were 182 patients aged 31-76 (mean 42.8±11) years with acute destructive pancreatitis. All patients admitted to the 1st and the 2nd surgical departments of the Kazan City Hospital No. 7 for the period from 2017 to 2019. There were 78 (43%) men and 104 (57%) women. Two groups of patients were distinguished in order to compare the effectiveness of stenting of the main pancreatic duct in acute pancreatitis: main group (34 patients including 14 men and 20 women) - stenting of the main pancreatic duct, control group (50 patients including 20 men and 30 women) without stenting.
Results:
Complex diagnosis and treatment of acute pancreatitis in intensive care unit with percutaneous drainage of fluid accumulations under ultrasound control and stenting of the main pancreatic duct reduce postoperative mortality from 16% in the control group (n=50) to 9.2% in the main group (n=34). Moreover, this approach is valuable to localize the foci of pancreatic necrosis in 79% of cases. the An efficiency of endoscopic decompression of the main pancreatic duct was 42% in patients with alcoholic pancreatitis.
Conclusion:
Endoscopic stenting of the main pancreatic duct is effective for pathogenetic treatment of patients with biliary pancreatitis, aimed at reducing intraductal hypertension in the early stages of disease.
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