Mamontov I. Diagnostics and treatment peculiarities of severe acute pancreatitis

Results of 217 patients with acute pancreatitis treatment were presented in the paper. The main group was arranged of 107 patients in which the defi-nition of acute pancreatitis severity and the treatment were carried out on the basis of worked out criteria. The group of comparison was arranged of 110 patients. On the basis of the most informative ultrasonic, laboratory and clinical features diagnostic scale and scheme were worked out, allowing to define severity of acute pancreatitis in 91,6 % cases. Analysis of examination and treatment of the patients with biliar pan-creatitis demonstrated the existence of two etiopathogenetic variants: chole-cystogenetic, when acute pancreatitis combines with acute cholecystitis, and ductogenetic, when duct hypertension is the etiologic factor. Objective criteria for inclusion into conservative therapy prolonged peridural anesthesia, antibacterial and anticoagulant therapy were defined On the basis of visualizing methods of examination. It was detected, that system inflammatory response syndrome is the index for urgent fluid collections evacuation. Open operations should be performed if formed sequesters or purulent complications exists. In case of severe acute pancreatitis suggested treatment tactics allowed to decrease general lethality from 28,8% to 21,2%, post-operative - from 22,2% to 13,5%, decrease the necessity of recurring intrusions from 35,5% to 16,2%, and the number of post-operative complication - from 37,5% to 14,3%. Key words: acute pancreatitis, diagnostics of severity, conservative treatment, endoscopic treatment, surgical treatment.