Abstract
Background. Mini-invasive percutaneous echo-controlled puncture drainage interventions have certain limitations in case of location of local complications of acute pancreatitis of the right and central-right type due to the high risk of iatrogenic injuries as a result of possible uncontrolled advancement of the working part of the device.
Aim: to improve the results of surgical treatment of patients with acute pancreatitis through the introduction of improved techniques of miniinvasive percutaneous echo-controlled interventions in complicated course of the disease.
Materials and methods. The study was based on the results of examination of 187 patients with severe acute pancreatitis, who were divided into two groups: a comparison group – patients who used traditional methods of examination and treatment (n=92) and the main group – patients who used improved surgical tactics (n =95). To assess the effectiveness of surgical tactics in the studied groups, a comparative analysis of the applied methods, the frequency of postoperative complications, mortality, and the duration of hospitalization was carried out.
Results. The introduction of improved miniinvasive percutaneous echo-controlled surgical interventions expanded the possibilities of their use, including in the localization of infected local complications of the right and central-right type, and probably increased their effectiveness by 41.8% (p=0.02). A comparative analysis of the duration of inpatient treatment in the studied groups revealed a probable reduction in the terms of hospitalization of patients in the main group by 14.7 days (р=0.0008), of which in the intensive care unit – by 4.7 days (р<0.0001).
Conclusion. The use of improved methods of diagnosis and treatment in patients of the main group made it possible to reliably reduce the frequency of postoperative complications by 28% (p=0.003) and overall postoperative mortality by 27.7% (p=0.005).
Publisher
Bogomolets National Medical University