Comparative study of surgical treatment methods in patients with severe acute pancreatitis complicated by enzymatic peritonitis

Abstract

Introduction. Treatment of acute pancreatitis remains one of the most difficult and urgent – severe forms require surgical intervention. The purpose of the study. To substantiate the expediency of using an innovative method of surgical treatment of patients with severe acute pancreatitis complicated by enzymatic peritonitis.
Materials and methods of research. 80 patients (25–80 years old) with severe acute pancreatitis participated. The experimental group consisted of 40 patients receiving treatment using the method developed by us using the "Heptral" in the round ligament of the liver and external drainage of the biliary tract. The control group consisted of 40 patients (standard treatment).
Treatment results. Experimental group showed favorable results: there was a marked decrease in LII by day 10, reflecting effective relief of the systemic inflammatory response. Significantly significant differences were found in the following parameters: the level of leukocytes in the postoperative period, the level of triglycerides in dynamics, the level of C-reactive protein, the level of diastase (urine). In the main group, there was a significant decrease in amylase activity by days 5 and 10, while in the control group this indicator remained high. In the main group, creatinine levels were 3–5 days lower than in the control group, indicating a lower severity of renal dysfunction.
Conclusions. Use of “Heptral” in the circular ligament of the liver with external drainage of the biliary tract as a method of surgical treatment increases the effectiveness of therapy for severe acute pancreatitis complicated by enzymatic peritonitis. Method is patented (patent for invention).