Pisotskiy O. Prophylaxis and treatment of the second pancreatic infection by the surgical treatment of patients with severe acute pancreatitis (clinic-experimental research)

Object of the study:severe forms of acute pancreatitis Purpose of the study:: improvement of the results of surgical treatment of patients with acute pancreatitis. Methods of the study: general clinical, biochemical, immunological, immune-enzyme, cytologic, endoscopic assays, ultrasonic diagnostic. Practical significance of the obtained results:The evaluation of systemic blood flow concentrations of acute-phase inflammatory markers (IL-8, C-reactive protein) in combination with APACHE II scale in the dynamics of treatment of patients with severe acute pancreatitis, enables to identify the group of patients with high risk of development of the secondary pancreatic infection. The proposed methods for the disease course prediction, immune correction, the use of mini-invasive endoscopic interventions and deescalation approach to the choice of initial regimen of antibacterial prophylaxis system and treatment in patients with severe acute pancreatitis make it possible to achieve the most favorable results oftreatment. Novelty: The method has been worked out for acute pancreatitis course prognosis with the highest prognostic significant indices in the case of the development of secondary pancreatic infection according to the level of IL-8, С-reactive protein and degree of the patient's state severity as determined by APACHE II scale. The new method has been proposed for the immune-modeling therapy, which consists in the diagnostic of the systemic inflammatory reaction detection by means of evaluation of patient's blood serum IL-8 levels, and its blockade in the case of infected pancreatic necrosis. Degree of introduction:The results of the study have been introduced in the work of surgical departments of Kharkov emergency municipal clinical hospital, of the 26th and 2nd Kharkov hospitals and in the surgical departments of the Institute of General and Emergency Surgery of AMS of Ukraine. Area of application: medicine, surgery.