MODERN ASPECTS OF DIAGNOSTIC AND SURGICAL TREATMENT OF CHRONIC PANCREATITIS COM-PLICATED FORM

At present there is a steady increase in the incidence of chronic pancreatitis (CP), in the world it is 3.1-8 cases, in European countries - there are 4-8 cases, prevalence is - 25 cases per 100 thousand of population. There is currently no clear consensus on the optimal method of diagnostics and the use of various methods of study of the CP, and even more so with affected adjacent organs. Indications for surgical treatment of CP are not sufficiently defined. The aim of the study was to improve the results of di-agnostics and surgical treatment of patients with complicated forms of CP with a disorder of the function of adjacent organs. The analysis of the results of the examination and treatment of 182 patients with CP was performed. 43.9% of patients had clear symptoms of damage to neighboring organs caused by chronic pancreatitis. Most often there was biliary hypertension. On the basis of the comprehensive BH study, the sen-sitivity of the instrumental methods for detection of BH in CP was determined. The obtained data indicate the high sensitivity of the methods of ERCHP, MRCHP, CT and IOM BP. Methods of surgical treatment of CP included drainage, resection and indirect (palliative) surgical interventions. In 99 (54.4%) patients resection-type operations were performed. The operations of the drainage type were performed in 77 (42.3%) patients. In 6 (3.3%) patients with severe concomitant pathology there were performed symptomatic operations. In patients with the disorders of the function of adjacent organs, resection-type operations were used in 76.3% of cases. In the study of long-term results, the quality of life in-dicators in patients who undergone resection operations on pancreas were the best ones. The performed objective studies, laboratory and ultrasound data indicated that patients had no signs of abnormalities in adjacent organs in the long-term period after surgery. Chronic pancreatitis is a serious illness in which 15.1% have signs of endocrine insufficiency of the pancreas, 79.2% have exocrine insufficiency, and 43.9% have symptoms of abnormalities in the function of adjacent organs. The absence of well-defined indications for surgical intervention of chronic pancreatitis leads to its long and ineffective conservative treatment, often leads to delayed hospitalization in the surgical hospital and, ultimately, - to not always positive results of the operation. The main methods of surgical treatment of patients with CP are resection, which we used in 54.3% of cases, but in patients with a violation of the functions of adjacent organs, the specific weight of such irregular interferences increases to 76.3%.