Purulent-Necrotic Parapancreatitis: the Evolution of Views on Treatment

Autor:	E. V. Batig, V. E. Savello, V. R. Gol’tsov, D. M. Kurochkin, D. A. Dymnikov, A. M. Bakunov
Rok vydání:	2018
Předmět:	medicine.medical_specialty Hepatology medicine.diagnostic_test business.industry Incidence (epidemiology) Mortality rate Gastroenterology Magnetic resonance imaging Surgery Angiography medicine business Surgical treatment Severe sepsis Minimally invasive procedures
Zdroj:	Annaly khirurgicheskoy gepatologii = Annals of HPB surgery. 20:75-83
ISSN:	2408-9524 1995-5464
Popis:	Aim. To develop more effective methods of surgical treatment of patients with purulent-necrotic parapancreatitis. Material and Methods. Treatment of 819 patients with purulentnecrotic parapancreatitis was analyzed. The volume of pancreatic necrosis and extent of purulent-necrotic parapancreatitis were determined according to multispiral computed tomographic angiography or magnetic resonance imaging, as well as during surgery or autopsy. Different surgical methods were compared depending on time and type of surgery. Effectiveness was estimated according to incidence of complications, severe sepsis and mortality rate. Conclusion. Minimally invasive drainage under x-ray guidance with step-by-step replacement of drains to larger diameter followed by aspiration and/or instrumental necrosectomy is preferable in treatment of purulent-necrotic parapancreatitis. Laparotomy with necrosectomy are ad-visable if minimally invasive procedures are ineffective.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_________::acdc9bd63cf6f4ba9c12884fba6fc90f https://doi.org/10.16931/1995-5464.2015375-83 Zobrazit plný text záznamu