Gorbenko K. Pancreatic injuries and their correction in the complex surgical treatment of patients with polytrauma.

Dissertation is devoted to the optimization of diagnosis and surgical treatment of pancreatic injuries in patients with polytrauma by applying the method of biological electrowelding, improving pharmacological vegetative blockade of the gland and determination of the most informative laboratory indexes in dynamic course of traumatic disease. Scientific research is based on based on retrospective data analysis of medical records and the results of a comprehensive clinical and laboratory examination and surgical treatment of 100 patients with the trauma of the pancreas. It was established that pancreatic injuries often occurs as a result of accidents, mostly in men with isolated abdominal trauma in 31% and in most cases combines with the trauma of liver and spleen. Its most common option is the organ contusion and injury severity scale by AIS <II. The efficiency of improved method of pharmacological vegetative blockade of the pancreas through cholecystostomy using ropivacaine solution for the prevention and treatment of posttraumatic complications in patients with polytrauma, which significantly reduces the amount of posttraumatic pancreatitis relative to the comparison group, was determined. It was proved that using of the biological electrowelding technology in patients with pancreatic ruptures can reduce the amount of posttraumatic pancreatitis relatively to the comparison group. It was established that the determination of biochemical markers, such as hyperamilasemia, hypertriglyceridemia, hyperglycemia, insulin resistance, lipid peroxidation indexes and total antioxidant activity in the dynamics of traumatic disease, each of which individually are not pathognomonic for acute pancreatitis in combination can significantly increase the effectiveness of forecasting the development of the complications in patients with the pancreatic injuries. Thus, the optimization of surgical treatment of pancreatic injuries using the proposed methods and the definition of informative markers for the diagnosis of posttraumatic pancreatitis can reduce pancreatic complications and provide more effective rehabilitation of patients with polytrauma.