Dyrda O. Prognosis of infection and surgical correction of local complications of patients with acute necrotizing pancreatitis

New way of decision of scientific task - to increase the results of surgical treatment patients with acute necrotizing pancreatitis is theoretically justified this dissertation analysis of results of survey and integrated treatment 151 patients with acute necrotizing pancreatitis with moderate and severe disease progression according to classification of Atlanta (2012) and 10 healthy donors lays in the base of this work. On the base of indicators of the functional reserves and metabolic direction of phagocytes of peripheral blood during early phase of disease of group of patients with high probability of development of infective complication of acute necrotizing pancreatitis (48,6 %) was distinguished. Using improved algorithm of treatment patients with acute necrotizing pancreatitis of risk group of development infectious complications that provides for implementation early minimally invasive puncture - draining intervention under ultrasound control concerning acute necrotic collection with progressive infiltration of retroperitoneal space with exudates for decompression, using individualized immunomodulated therapy and de-escalation antibiotic therapy give opportunity to reduce frequency of infectious complication from 24,6 to 14,3 %, mortality with infectious complications - from 40,0 to 20,0 % and total mortality from 9,8 to 2,9 %. A generalized assessment of the risk of complications based on the indicators of treatment effectiveness indicates a statistically significant reduction in the risk of complications in general by 52 % (OR = 0.48 (0.23-0.97), p = 0.04).