Shadrin O. Choice of endoscopic biliary decompression method in patients with acute billiary pancreatitis

The results of treatment of 263 patients of acute biliary pancreatitis with biliary obstruction were investigated. In 148 patients of basic group we use original methods of diagnostics and treatment. In 115 patients we use standard treatment methods. Balloon dilatation, used in 68,2 % patients of basic group, allowed to save Oddy's sphincter function. In a basic group dilatation used in case of intact papilla, papillotomy used in case of fibrous changes, nasobiliary drainage in case of edema. The methods of impedance spectrum measurement and control of the pressure level during the dilatation allowed to diagnose morphological changes in papilla. with the sensitiveness of 98 % and specificity of 97 %, temperature measurement allowed cholangitis diagnostic with a sensitiveness and specificity 87,5 % and 65,4 % respectively. Application of early endoscopic decompression reduced frequency of serve forms of pancreatitis from 18,9 % to 13,5 %, compared to traditional approaches (rise from 22,6 % to 26,9 %), as well as decrease the hospital stay, pain duration, normalization of serum billirubin and amylase level, need in operative treatment and complications rate.