MINI-INVASIVE TREATMENT OF POSTNECROTIC PSEUDOCYSTS OF PANCREAS
DOI:
https://doi.org/10.11603/2414-4533.2016.2.6414Abstract
This article adduces the results of treatment of 71 patients with postnecrotic pseudocysts of pancreas, which appear after acute
postnecrotic pancreatitis. Among them there are 51 males and 20 females aged from 18 to 79 years. The main reasons of this disease
were alcohol abuse and alimentary factor in 64 (90.1 %), calculi in bile duct – in 7 (9.9 %) patients. Volume of postnecrotic
pseudocysts was 65–1980 cm3. Complications that cause necessity of laparotomy in 24 (33.8 %) patients were isolated and multiple
infected pseudocysts with large walled of necrosis within progression of pancreonecrosis, purulent peritonitis and two–sided retroperitoneal
phlegmon – in 19 (79.1 %), abscesses of abdominal cavity – in 5 (20.9 %) patients. Progression of these complications
were observed on 7–38 day after starting of disease. Terms on stationary treatment were 22–58 days. In 47 (66.2 %) patients were
applied miniinvasive methods of treatment. Percutaneous external drainage in 25 (53.1 %), endoscopic transmural drainage of
postnecrotic pseudocysts – in 8 (17.1 %) patients. Combined endoscopic interventions were applied in 14 (29.8 %) patients. In
particular, endoscopic transmural drainage with temporary stenting of pancreatic duct – in 9 (64.2 %), endobiliary stenting with
temporary stenting of pancreatic duct – in 2 (14.2 %) patients, temporary stenting of pancreatic duct – in 2 (14.2 %) patients, endoscopic
transmural drainage with percutaneous external drainage in one patient. Miniinvasive and endoscopic interventions were
applied on 4–8 week after starting of disease. Terms of stationary treatment were 12–14 days. Established priority of miniinvasive
methods of treatment. There were determined indications for applying them for postnecrotic pseudocysts of pancreas.
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