Preview

Grekov's Bulletin of Surgery

Advanced search

The choice of surgical treatment in patients with infected pancreonecrosis

https://doi.org/10.24884/0042-4625-2018-177-6-20-26

Abstract

The objective is to study the results of different methods of surgical treatment of patients with infected pancreonecrosis and to conduct a comparative analysis of minimally invasive and traditional surgical interventions.

Material and methods. The results of treatment of 206 patients with infected pancreonecrosis were analyzed. In accordance with the used method of surgical treatment, the patients were divided into 2 groups: 105 (51.0%) patients with “traditional” open interventions were included in the first group (comparison), and 101 (49.0%) patients treated with various miniinvasive technologies, or a combination of minimally invasive and “open” interventions were included in the second group.

Results. It was found that the mortality rate in the second group was less than in the first group by 12.8% (p<0.05).

Conclusion. Minimally invasive surgical techniques are the method of choice for delimited pancreatogenic ulcers. The use of combined surgical interventions leads to a significant reduction of postoperative mortality and duration of inpatient treatment.

About the Authors

E. A. Tseimakh
Federal State Budgetary Educational Institution of Higher Education «Altai State Medical University» of the Ministry of Healthcare of the Russian Federation; Regional State Budgetary Institution of Healthcare «Regional Clinical Hospital of mergency Medicine».
Russian Federation


V. A. Bombizo
Regional State Budgetary Institution of Healthcare «Regional Clinical Hospital of mergency Medicine».
Russian Federation


P. N. Buldakov
Federal State Budgetary Educational Institution of Higher Education «Altai State Medical University» of the Ministry of Healthcare of the Russian Federation; Regional State Budgetary Institution of Healthcare «Regional Clinical Hospital of mergency Medicine».
Russian Federation


A. A. Averkina
Federal State Budgetary Educational Institution of Higher Education «Altai State Medical University» of the Ministry of Healthcare of the Russian Federation; Regional State Budgetary Institution of Healthcare «Regional Clinical Hospital of mergency Medicine».
Russian Federation


D. N. Ustinov
Regional State Budgetary Institution of Healthcare «Regional Clinical Hospital of mergency Medicine».
Russian Federation


A. V. Udovichenko
Federal State Budgetary Educational Institution of Higher Education «Altai State Medical University» of the Ministry of Healthcare of the Russian Federation; Regional State Budgetary Institution of Healthcare «Regional Clinical Hospital of mergency Medicine».
Russian Federation


References

1. Savel’ev V. S. Pankreonekrozy. MIA, 2008. 264 p. (In Russ.).

2. Gol’tsov V. R., Savello V. E., Bakunov A. M. i dr. Gnoino-nekroticheskii parapankreatit: evolyutsiya vzglyadov na taktiku lecheniya. Annaly khirurgicheskoi gepatologii. 2015. Vol. 20, № 3. P. 75–83 (In Russ.).

3. Nartailakov M. A., Gvozdik T. P., Dorofeev V. D. Osobennosti vedeniya pankreonekroza, oslozhnennogo rasprostranennym peritonitom. Materialy plenuma pravleniya assotsiatsii gepatopankreatobiliarnykh khirurgov stran SNG. Samara, 2015. P. 106–108 (In Russ.).

4. Aranda-Narváez J. M., González-Sánchez A. J., Montiel-Casado M. C. et al. Acute necrotizing pancreatitis: Surgical indications and technical procedures // World J. of Clin. Cases. 2014. № 2 (12). Р. 840–845. Doi: 10.12998/wjcc.v2.i12.840.

5. Feng Y. C., Wang M., Zhu F. et al. Study on acute recent stage pancreatitis // World J. of Gastroenterology. 2014. № 20 (43). Р. 16138–16145. Doi: 10.3748/wjg.v20.i43.16138.

6. Firsova V. G., Parshikov V. V. Ostryi pankreatit: sovremennye podkhody k khirurgicheskomu lecheniyu. Vestnik eksperimental’noi i klinicheskoi khirurgii. 2012. Vol. 5, № 4. P. 715–721. (In Russ.).

7. Isaji S., Takada T., Kawarada Y. et al. JPN Guidelines for the management of acute pancreatitis : surgical management // Journ. of hepato-biliary-pancreatic surgery. 2006. № 13 (1). Р. 48–55. Doi: 10.1007/s00534-005-1051-7.

8. Amano H., Takada T., Isaji S. et al. Therapeutic intervention and surgery of acute pancreatitis // Journ. of hepato-biliary-pancreatic sciences. 2010. № 17 (1). Р. 53–59. Doi: 10.1007/s00534-009-0211-6.

9. Doctor N., Philip S., Gandhi V. et al. Analysis of the delayed approach to the management of infected pancreatic necrosis // World J. of Gastroenterology. 2011. № 17 (3). Р. 366–371. Doi: 10.3748/wjg.v17.i3.366.

10. Bagnenko S. F., Blagovestnov D. A., Gal’perin E. I., Dyuzheva T. G., Dibirov M. D., Prudkov M. I., Filimonov M. I., Chzhao A. V. Ostryi pankreatit(protokoly, diagnostika i lechenie). 2014. (In Russ.). URL: http://обществохирургов.рф/arhivy­nkr/ostryi­pankreatit­protokoly­diagnostika­i­lechenie.html

11. Zatevakhin I. I., Kirienko A. I., Kubyshkin V. A. Ostryi pankreatit. Abdominal’naya khirurgiya. Natsional’noe rukovodstvo. М.: GEOTAR­Media, 2016. P. 716–734. (In Russ.).

12. Bobrov O. E., Mendel’ N. A. Nekotorye mify i real’nosti ostrogo pankreatita. Donetsk, 2010. 160 p.

13. Drugakova Yu. S. Abdominal’nyi sepsis pri pankreonekroze. Byulleten’ meditsinskikh Internet­konferentsii. 2014. Vol. 4, № 5. P. 837. (In Russ.).

14. Pavlikova E. Yu. Diagnostika pankreonekroza i ego posleoperatsionnykh oslozhnenii. Literaturnyi obzor. Vestnik Rossiiskogo nauchnogo tsentra rentgenoradiologii Minzdrava Rossii. 2010. Vol. 1, № 10. P. 8. (In Russ.).

15. Litvin A. A., Khokha V. M., Lur’e V. N. Sovremennye tendentsii v khirurgicheskom lechenii ostrogo nekrotiziruyushchego pankreatita, infitsirovannogo pankreonekroza. Novosti khirurgii. 2011. Vol. 19, № 5. P. 138–146. (In Russ.).


Review

For citations:


Tseimakh E.A., Bombizo V.A., Buldakov P.N., Averkina A.A., Ustinov D.N., Udovichenko A.V. The choice of surgical treatment in patients with infected pancreonecrosis. Grekov's Bulletin of Surgery. 2018;177(6):20-26. (In Russ.) https://doi.org/10.24884/0042-4625-2018-177-6-20-26

Views: 702


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 0042-4625 (Print)
ISSN 2686-7370 (Online)