Article 8421

Title of the article

Using modified drainage device in the treatment of infected pancreatic necrosis 

Authors

Vladimir V. Khatsko, Doctor of medical sciences, professor, professor of the sub-department of surgery named after K.T. Ovtanyan, Donetsk National Medical University named after M. Gorky (16 Ilyicha avenue, Donetsk, Ukraine), E-mail: x3x3x23@rambler.ru
Aleksandr E. Kuz'menko, Candidate of medical sciences, associate professor, associate professor of the sub-department of surgery named after K.T. Ovtanyan, Donetsk National Medical University named after M. Gorky (16 Ilyicha avenue, Donetsk, Ukraine), E-mail: kuzmenko-1969@mail.ua
Oleg K. Zenin, Doctor of medical sciences, professor, professor of the sub-department of human anatomy, Medical Institute, Penza State University (40 Krasnaya street, Penza, Russia), E-mail: zen.olegz@gmail.com
Aleksandr N. Mitroshin, Doctor of medical sciences, professor, head of the sub-department of surgery, Medical Institute, Penza State University (40 Krasnaya street, Penza, Russia), E-mail: pmisurg@gmail.com
Vladimir V. Potapov, Candidate of medical sciences, assistant of the sub-department of anesthesiology, intensive care, emergency medicine, Donetsk National Medical University named after M. Gorky (16 Ilyicha avenue, Donetsk, Ukraine), E-mail: x3x3x23@rambler.ru 

Index UDK

616.37-002.4:615.28 

DOI

10.21685/2072-3032-2021-4-8 

Abstract

Background. In recent years, the problem of pancreatic necrosis in urgent surgery has been at the forefront. Infected pancreatic necrosis (IPN) occurs in 38–69 % of patients with severe acute pancreatitis, mortality in this pathology reaches 8–49 %. The aim of the work – to increase the efficiency of treatment of patients with infected pancreatic necrosis and acute destructive pancreatitis by using an original drainage device. Materials and methods. The analysis of the results of treatment of 102 patients with IPN, who underwent different types of operations, depending on the prevalence of the process, was carried out. Women were 29 (28.4 %), men – 73 (71.6 %), aged from 27 to 74 years. We used traditional methods of patient examination. Two groups were formed. The 1st group (main) consisted of 43 (42.1 %) patients, in whom the traditional complex of therapeutic and diagnostic measures was used in combination with the developed “drainage device”. 59 (57.9 %) patients of the 2nd group (control) underwent standard medical and diagnostic practice. Results. A total of 102 patients underwent 186 operations: 96 - minimally invasive and 90 – by the traditional “open” method. The number of postoperative complications in the 1st group of patients was 8 (7.8 %), in the 2nd group – 18 (17.6 %) with a mortality rate of 5 (11.6 %) and 16 (27.1 %), respectively. The most common cause of death was sepsis with multiple organ failure. Conclusions. It is necessary to combine minimally invasive and “open” operations for infected pancreatic necrosis against the background of complex therapy. In 23.4 % of patients, minimally invasive technologies are the final method of treatment. The use of the developed “drainage device” leads to a significant reduction in complications and mortality. 

Key words

infected pancreatic necrosis, treatment, operations, drainage device 

Download PDF
References

1. Andreev A.V., Ivshin V.G., Gol'tsov V.R. Treatment of infected pancreatic necrosis with minimally invasive interventions. Annaly khirurgicheskoy gepatologii = Annals of surgical hepatology. 2015;20(3):110–116. (In Russ.)
2. Gallyanov E.A., Agapov M.A., Lutsevich O.E., Kakotkin V.V. Modern technologies for the treatment of infected pancreatic necrosis: a differentiated approach. Annaly khirurgicheskoy gepatologii = Annals of surgical hepatology. 2020;25(1):69–78. (In Russ.)
3. Verkhuletskiy I.E., Rozenko O.V., Osipov A.G. [et al.]. The role of peritoneal lavage with ozonized physiological saline in the treatment of enzymatic peritonitis in destructive pancreatitis. Ukrainskiy zhurnal khirurgii = Ukrainian journal of surgery. 2010;(2):73–75. (In Russ.)
4. Timerbulatov V.M., Timerbulatov Sh.V., Timirkhanov Sh.A. Long-term regional arterial infusion in the treatment of acute pancreatitis. Annaly khirurgicheskoy gepatologii = Annals of surgical hepatology. 2014;22(4):96–101. (In Russ.)
5. Darvin V.V., Krasnov E.A., Kislitsin D.P. [et al.]. Severe acute pancreatitis: assessment of treatment outcomes and opportunities for improvement. Al'manakh Instituta khirurgii im. A. V. Vishnevskogo = Almanac of the Institute of surgery named after A. V. Vishnevskiy. 2019;(2):12–13. (In Russ.)
6. Kulezneva Yu.V., Moroz O.V., Izrailov R.E. [et al.]. Percutaneous intervention for purulent-necrotic complications of pancreatic necrosis. Annaly khirurgicheskoy gepatologii = Annals of surgical hepatology. 2015;20(2):90–97. (In Russ.)

 

Дата создания: 22.02.2022 13:49
Дата обновления: 24.02.2022 13:46