Zhuravl'ova Y. Acute cholepancreatitis. Question of optimization of surgical tactics with use videoendoscopic techniques

The Dissertation is devoted to questions of optimization of surgical tactics at acute cholepancreatitis (ACP). For optimization of rendering emergency the help this patient expediently allocation 4 forms of АСР: calculous, calculous-free, fermental and parasitic (with gangrenous organs or without gangrenous changes). Surgical treatment was carried out by the patient with gangrenous calculous-free, fermental and calculous forms ACP. At parasitic and calculous-free forms ACP without gangrenous changes conservative treatment is necessery. It is necessary to count basic elements of operative treatment ACP: videoendoscopic cholecystectomy, maintenance of adequate outflow of bile with the help external drainage the common bilious ducts, wide drainage a abdominal cavity with obligatory drainage bursa omentalis through Winslov an aperture or through ligamentum hepatogastricum a sheaf. Application videoendoscopic a method of treatment ACP has allowed to lower quantity of postoperative complications from 26,1 %to 8,6 %, postoperative mortality from 17,4 % up to 5,2 %, terms of treatment were reduced on the average with 23,6i3,3 up to 17,3i2,6 days (in comparison with laparotomy a way of treatment of patients ACP).