Voronov A. Diagnostics and operative treatment of complications of the infected pancreatic necrosis

The scientific work is dedicated to the development of the algorithm of diagnostics and management of the patients with pancreatic necrosis and the infectious complications of it. Algorithm is based on combination of the complex of laboratory investigation, instrumental examination and dynamic assessment of severity of the patient’s condition. The exact indications for the US-guided puncture and laparoscopy were worked out. It was shown that early operations on the base of analysis of results of the early and late operative treatment, that was made on the rate of mortality and the impact of primary and repeated operations on severity of the patient’s condition, had not improved the state. Modified transverse laparotomy is more acceptable in comparison with upper midline laparotomy from the position of criterions of surgical incision assessment. Approaches to the treatment of infected pancreatic necrosis and it’s complications that were worked out allowed to decrease lethality rate. Study of antiendotoxin antibodies levels show that their determination has a potential importance in prediction of development of infection in the first phase of disease and allow to suspect it in second phase. Despite of aberration in endocrine and exocrine function of the pancreas the patient's quality of life decreases insignificantly and through deterioration of the physical component.