Oganezyan A. Surgical approach at separate fluid collections in patients with severe acute pancreatitis

The aim of the dissertation is to improve the results of treatment of patients with severe acute pancreatitis by determining the indications, the timing and the methods of minimally invasive and open surgical interventions for separate fluid collections. A method of the evaluation of puncture-draining interventions under ultrasound guidance on the basic of the results of laboratory, instrumental examinations, separate fluid collections contents rating in time of puncture-draining interventions, course of the disease. Study innate immunity receptor gene polymorphism (TLR-2, TLR-4) and the expression level of gene TLR-4 in peripheral blood mononuclear cells in the development of infected separate fluid collections at severe acute pancreatitis more insightful and predictive value of clinical, laboratory, instrumental data in the development of infected separate fluid collections. Enhancing level of gene expression TLR-4 can be used as a marker of genetically determined risk of infection separate fluid collections. Using the scale of evaluation of puncture-draining interventions under ultrasound guidance improves the results of treatment of patients with separate fluid collections at severe acute pancreatitis. The proposed surgical approach at separate fluid collections in patients with severe acute pancreatitis cases possible to reduce complications rate by 15.1% and mortality rate by 16.4%.