Authors
Gulov M.K., Ruziboyzoda K.R., Nosirov E.Sh., Alizadeh S.G., Nosiri K.N., Safarov B.I.
Avicenna Tajik State Medical University, Dushanbe, Republic of Tajikistan
Abstract
Aim. Improving the effectiveness of complex treatment of patients with acute pancreatitis by introducing a personalized approach.
Material and methods. The study analyzed the outcomes of surgical intervention in 126 patients with various clinical forms of acute pancreatitis. The subjects were divided into two groups: the first, prospective group, which included 62 patients, and the second, retrospective group, which included 64 patients. In most cases (70.6%, or 89 patients), acute pancreatitis was of biliary origin (due to cholelithiasis), in 22.2% (28 patients) of cases, this pathology was of alcoholic origin, and in 7.2% (9 patients) cases — post-traumatic.
Results. Complex conservative treatment was carried out in 28 (22.2%) cases, among them in 17 patients from the main group and 11 patients from the control group with acute pancreatitis of alcoholic and post-traumatic origin. Minimally invasive interventions of varying volume and nature (percutaneous-drainage, endoscopic and laparoscopic), both one-stage and two-stage combined interventions in the main group were used in 38 (30.2%) patients. Traditional open surgical interventions in general were performed in 60 (47.6%) patients, of which in 7 (11.3%) cases according to strict indications in patients of the main group, and in patients of the control group — in 53 (82.8%) observations. In 20 (12%) observations, the development of early complications was noted after both complex drug treatment and after various surgical interventions in patients from the main group. Death occurred in 4 (6.4%) cases. In the control group of patients, 44 (68.7%) patients developed early complications of various types. Death in the control group occurred in 9 (14.1%) cases.
Conclusion. Thus, the choice of tactics and method of treatment, conservative or surgical approach using modern minimally invasive technologies for acute pancreatitis, must be strictly personalized. This choice depends on the cause of the disease, its clinical form and stage of development, as well as the presence of complications.
Keywords: acute pancreatitis, pancreatic necrosis, personalized approach, conservative treatment, minimally invasive interventions, laparotomy.
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