SURGICAL TREATMENT OF ACUTE NECROTIC PANCREATITIS

Purpose: to conduct the analysis of surgical treatment of patients with acute necrotic pancreatitis and to identify clinical parameters, which reflect the high probability of an unfavorable course of the disease. Methods. There is an analysis of surgical treatment of 125 patients with severe acute pancreatitis. In postoperative period 34 (27,2%) patients died. The analysis of clinical characteristics of patients with the isolation of a group of patients who died in the hospital from complications of pancreatic necrosis was carried out. Results. The average age of the patients was (60,5±3,56) years. In comparison with the average age of the survived patients (47,75±1,89) years. Analysis of mortality by gender showed that among those women who survived were 31 (68,89 %), among those men who survived - 60 (75 %) (p>0.05). The systemic inflammatory response syndrome detected in 75 (60 %) patients. Acute organ failure was detected in 107 (85.6 %) patients. Infected necrosis revealed at 80 (64,0%) patients. In the group of died infected necrosis revealed at 30 (88,2%) patients. Parapancreatic fat injury was revealed at 80 (64,0%) patients. In 26 (76,5%) patients of 34 died, parapancreatic fat injury was revealed. In the analysis of concomitant diseases, it has been re-vealed that among patients with cachexia, obesity and alcoholism, the mortality rate was 100%. Among patients with chronic liver disease and kidney disease mortality rate was 54,2%, among patients with pathology of the cardiovascular system rate was 47.6% (p<0.05). Conclusions: 1. Postoperative mortality from complications of acute necrotizing pancreatitis is 27.2%. However, infected pancreonecrosis and parapancreatic fat injury revealed at 64% of patients with acute necrotizing pancreatitis. 2. High risk of mortality in patients with severe acute pancreatitis is caused by the nature of the injury of the pancreas and retroperitoneal fat, age, alcoholic etiology of the disease, presents of disorders of body weight, diseases of liver, kidneys, cardiovascular system.