Klymenko M. Diagnostic and prognostic value of cytokine reactivity in the choice of surgical tactics in Acute Pancreatitis

The dissertation deals with increasing the efficiency of surgical care for patients with Acute Pancreatitis (AP). It is shown that this topical issue can be solved using the developed algorithm for early diagnosis of the severity of AP and prediction of the formation of infected pancreatic necrosis based on the diagnostic and prognostic value of anti - inflammatory cytokine that is transforming growth factor TGF-b1 and other markers of acute phase of inflammation in the dynamics of the pathological process. The algorithm of diagnosis and choice of surgical tactics in AP based on the usage of diagnostic and prognostic levels of TGF-b1 and procalcitonin in an integrated assessment of the severity of patients in terms of following scales: Ranson, APACHE II, CT-index Balthazar. The algorithm permits to change differentially and in time the strategy of surgical intervention. It is possible to choose between "closed", "semi-open" and "open" surgical methods of treating AP. The developed algorithm of diagnosis and treatment can reduce the number of repeated traumatic interventions, decrease postoperative mortality by 6,4 % and diminish the time of hospitalization.