Tutka M. Features of surgical tactics in acute pancreatitis with disorders of carbohydrate metabolism

The dissertation work presents a theoretical and practical solution to the current problem of modern surgical pancreatology, namely, improving the results of treatment of patients with acute pancreatitis with existing glycemic disorders based on the implementation of the methodology of a multidisciplinary approach with the study of pathomorphological changes in the endocrine apparatus of the pancreas, elucidation of the factors of hyperglycemia development, as well as substantiation of surgical tactics through the priority use of minimally invasive surgical technologies. To achieve the goal, the tasks were set to study the features of carbohydrate metabolism disorders in acute pancreatitis with the determination of various factors of hyperglycemia development, to determine the level of glucose in parapancreatic fluid accumulations as an indicator of the occurrence of hyperglycemia; to study the features of pathomorphological changes in the pancreas, in particular its exocrine and endocrine apparatus in these categories of patients; to clarify the significance of carbohydrate metabolism disorders in the form of hyperglycemia as a prerequisite for the occurrence of pancreatogenic diabetes mellitus; to develop tactics for surgical treatment of patients with the priority use of minimally invasive surgical technologies. In accordance with the design of the study to achieve the goal and solve the tasks of the work. In accordance with the target guidelines of the scientific study, 96 patients with acute pancreatitis were subjected to a comprehensive examination, who from 2016 to 2022 were treated in the city pancreatic center of the city. Lviv, today "Hospital of St. Panteleimon", the clinical base of the Department of General Surgery of the Danylo Halytsky Lviv National Medical University and in which, based on clinical, laboratory-biochemical, additional - radiation (x-ray, ultrasound, computed tomography), instrumental (video-laparoscopic esophagogastroduodenoscopy), as well as according to specially performed studies (biochemical, pathomorphological), the presence of acute inflammatory damage to the pancreas - acute pancreatitis was ascertained.