Ahmed A. The Choice of tactics of treatment of patients with асut pancreatitis the burdened syndrome of a jaundice.

Object of the study: acute pancreatitis complicated with jaundice. Purpose of the study: Improvement of the treatment outcome in patients with acute pancreatitis complicated with jaundice by optimization of the existing diagnostic criteria and therapeutic measures and development of new ones. Methods of the study: Clinical and biochemical blood tests and statistical methods were used to evaluate the degree of homeostasis disturbances. Instrumental techniques (ultrasound study, fibrogastroduodenoscopy, laparoscopy) followed by cytology verification of the data with the study of the liver and pancreas bioptates were used to assess the degree of the inflammation progress in the pancreas and surrounding tissues as well as morphofunctional changes in the liver. Practical significance of the obtained results: To diagnose acute pancreatitis, the stages of its development as well as the character of the accompanying jaundice it was suggested to use noninvasive ultrasound study in urgent situations. Therevealed ultrasound criteria of the basic disease and accompanying changes in the liver allowed to suggest therapeutic diagnostic program aimed at improvement of the treatment results in these patients. It was suggested to include Erbisol (a drug with cytoprotecting and immune modulating properties providing quick normalizing of the liver function) to the complex therapy for acute pancreatitis with parenchymatous jaundice. Novelty of the obtained results: For the first time a method of dynamic observation of the course of acute pancreatitis with the study of the structure of the gland and the surrounding tissue as well as ultrasound differential diagnostic criteria of obturation and parenchymatous jaundice in patients with acute pancreatitis were worked out. For the first time a diagnostic algorithm of urgent examination of the patients with acute pancreatitis complicated with jaundice was worked out. The efficacy of Erbisol in treatment of acute pancreatitis complicated with jaundice was shown.The indications for minimum invasive surgery in acute pancreatitis complicated with jaundice were determined. A method of bile ducts drainage was suggested. Degree of introduction: The results of the research are used in the work of Surgery and Proctology department of Kharkiv Medical Academy for Advance Training, in surgery departments of City Clinical Hospital No. 18, Mykolaiv Regional Clinical Hospital, City Hospital No. 4 (Sumy), Regional Hospital (Kirovograd). The material of the work is used in the teaching process to post graduate students at Kharkiv Medical Academy for Advance Training. Area of application: medicine, surgery.