Ultrasonography in the Diagnosis and Treatment of Acute Pancreatitis

M.V. Konkova, M.L. Smyrnov., O.O. Yudin, A.P. Kondratenko, O.D. Bystrovа

Abstract


Diagnosis and treatment of acute pancreatitis (AP) remains an topical problem of modern surgery, and due to the numerous existing views on the issues of diagnosis, classification, development of diagnostic and treatment algorithms for selecting the evidence and mode of operation, its solving appears in the foreground in the system of specialized surgical care. Percutaneous puncture-drainage operative interventions under the supervision of ultrasound in the treatment pancreatonecrosis, unlike traditional surgical techniques, less traumatic, do not require using general anesthesia.
We analyzed the results of diagnosis and treatment of 416 patients aged 19 to 78 years who were in the clinic of surgery and endoscopy of Donetsk national medical university named after M. Gorky with AP (204 men and 212 women).
In 82 patients with complicated forms of AP we used minimally invasive intervention under ultrasound guidance, using method of simultaneous drainage with pig-tail needle catheter, drainages with size 6–9 Fr.
Types of minimally invasive procedures under ultrasound guidance:
— puncture and drainage of omental sac — 11 (13.4 %) patients;
— puncture and drainage of acute pseudocyst — 16 (19.6 %) patients;
— puncture and drainage of abscesses of the pancreas and/or omental sac— 8 (9.7 %) patients;
— puncture and drainage of retroperitoneal phlegmon — 26 (31.7 %) patients;
— drainage of free fluid accumulation in the abdominal cavity — 21 (25.6 %) patients.
Ultrasound examination is a highly effective non-invasive method for diagnosis of AP and its complications, that may makes it possible to assess objectively the state of the pancreas, inflammation type and its complications, to detail the stages of the pathological process, to determine timely the treatment strategy in these patients.
Minimally invasive interventions under ultrasound guidance are effective treatment regimen for treatment of complicated forms of pancreatonecrosis and in most cases help to avoid abdominal operations.


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DOI: https://doi.org/10.22141/1997-2938.2.25.2014.83064

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