The significance of the criteria for the depth and configuration of pancreatic necrosis in acute pancreatitis in the formation of complicated pseudocysts

Introduction. It is known that pseudocysts (PC) are a consequence of damage to the pancreatic duct in pancreatic necrosis.

The purpose of the study. To study the effect of the depth and configuration of pancreatic necrosis in acute pancreatitis on the dynamics of pancreatic pseudocysts in the long-term period.

Materials and methods. A retrospective analysis was carried out and the long-term results of treatment were studied in 29 patients with PC who underwent pancreonecrosis, in whom the depth and configuration of pancreatic necrosis were assessed on the basis of CT with bolus contrast.

Results. There were no PC complications in 9 patients, no signs of duct damage were noted during acute pancreatitis.In 16 out of 20 patients, PC complications (increasing collections, infection, hemorrhagic complications, rupture) occurred after deep necrosis of type 1 configuration, in 13 they were combined.With not deep necrosis of type 1 (1) and with 2 (3) type of configuration, only infection was noted.At the stage of PC complications, percutaneous drainage (total 12, in 3 after embolization), necrectomy from mini-access (2),endovascular interventions (total 6, 1 patient died), endoscopic cystogastroanastomosis (3) were performed.The result of the interventions in 10 patients was the forced formation of an external pancreatic fistula, which later required additional interventions.

Conclusion. Deep necrosis of the pancreas in type 1 configuration during acute pancreatitis are important criteria determining the likelihood of PC complications.

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