Smachylo R. Substantiation of endoscopic interventions in patients with acute pancreatitis in complex of medical treatment taking into consideration intestinal bacterial translocation.

Object of the study: acute pancreatitis. Aim: to work out and substantiate the complex of interventions with the use of endoscopic technologies directed to lowering of infectious morbidity in patients with AP. Methods of investigation and equipment: clinical, biochemical, blood gas analysis, morphological (histological and ultrastructure analysis), bacteriological, endoscopic (gastroduodenoscopy, laparoscopy), X-ray, ultrasound, statistic. Theoretical and practical results: Knowledge about role of intestinal bacterial translocation in development of infectious complications of AP was deepened. Diagnostic and therapeutic program based on endoscopic interventions was developed for patients with AP. Novelty: Early ultrastucture changes were determined in cells of small bowel mucous in experimental acute pancreatitis, which caused epithelial injury of gut barrier, that assists intestinal bacterial translocation. Risk groups of infectious complications among patients with AP and basic sources of endogenousinfection in them were defined. Diagnostic and strategy algorithms for prevention and treatment of infectious complications of AP with the use of endoscopic interventions were developed. The method of wound closure after laparoscopic operations and needle for its application were worked out. Degree of introduction: The developed algorithms of AP management were introduced into the clinical practice of Institute of General and Urgent Surgery of Academy of Medical Sciences of Ukraine, Kharkiv City Clinical Hospital of Urgent Medical Aid named after Prof. Meschaninov, 26th Kharkiv City Clinical Hospital, Balakliya Central District Hospital. The results of research are used during educational process in Department of Clinical Surgery of Kharkiv State Medical University. Use Sphere: Medicine, surgery.