Martinovsky A. Pancreanecrosis treatment.

According to the analysis of clinical material, three groups of patients have been singled out, to which different therapeutical-diagnostical measures should be applied, those are patients with local, spread pancreanecrosis and its purulent necrotic complications. The study of peculiarities of the disease course and of the theraputical methods efficiency has made it possible to create a therapeutical-diagnostical algorithm with individualized strategy depending on the spreading of destructive process and of purulent necrotic complications of pancreanecrosis, on the biliary system pathology, on the seriousness of the patient's state and on the number of risk factors influencing the undesirable course of the disease. On the basis of this, complex applying of conservative treatment, added by tissue therapy and of surgical intervention has been grounded. Operative treatment includes malinvasive, endoscopic and improved laparoscopic methods, applying the system of mini-accesses, stomas with subsequent drainage by means of the proposed drainage devices and programmed sanitations. Successive fulfillment of therapeutic-diagnostical algorithm has substantially reduced the number of purulent-necrotic complications and lethality, related to them.