[Choice of optimal policy for treatment of acute pancreatitis]

662 case records of patients with acute pancreatitis are analysed and principles for the choice of optimal treatment of patients with acute pancreatitis (AP) are established. The most justified policy in treatment of AD patients seems to be conservative-expectant. The treatment should satisfy the phases of the course of acute pancreatitis and severity of the disease. At the first stage of the disease the treatment should be aimed at correction of pancreatic toxemia and prophylaxis of pyogenic complications. Surgical interventions at this phase are risky and hardly justified. If there are indications for drainage, laparoscopy and small invasive interventions under US control are preferable. At the second stage conservative-expectant policy should be also used as a method of choice, and treatment should be aimed at prophylaxis of purulent complications. The presence of aseptic necroses are not an absolute indication for surgery if there are no clear signs of suppuration. The presence of purulent complications is an indication for surgical treatment; extraperitoneal approaches to pyogenous areas and their drainage by wide two-lumen tubes for the following use of aspiration--lavage treatment are more preferable.