METHOD OF LAPAROSCOPIC DRAINAGE OF RETROPERITONEAL FAT TISSUE IN EARLY PHASE OF ACUTE NECROTIZING PANCREATITIS

Objective. To reveal the regularities of liquid formations distribution in the parapancreatic zone of retroperitoneum and on the basis of the obtained data to develop a rational method of minimally invasive drainage of retroperitoneal fat tissue for the evacuation of pathological exudate in the early phase of acute necrotizing pancreatitis. Material and methods. The article presents the results of an anatomical experiment on 69 bodies of people who died from causes other than abdominal cavity and retroperitoneum diseases. We studied the ways of distribution of the fluid injected into various parts of the pancreas, as well as the effectiveness of retroperitoneal fat tissue drainage during the experiment. Results. The most vulnerable parts of retroperitoneal fat tissue during the distribution of pathological liquid from the pancreas are the root of mesentery, as well as the right and left paracolic gutters. It has been shown that the formation of tunnels in the retroperitoneal fat tissue behind the colonic flexures is an effective method that significantly improves the efflux of fluid from the parapancreatic zone, especially in left-sided lesions. Conclusions. The proposed method of laparoscopic drainage of retroperitoneal fat tissue is a minimally invasive drainage surgery, which is pathogenetically and anatomically substantiated and can be used as a part of early treatment of acute necrotizing pancreatitis.