Diapeutic Interventions in AP Treatment
Speaking of diapeutic interventions, a series of paracentetic interventions is applied at pseudocysts with the size no more than 5 cm and volume up to 40 ml. Expediency of sanation paracentetic interventions in pseudocysts is justified in case of an uncomplicated “acute” cyst of small size and in some cases of complicated pseudocysts with the absence of safe access to the cavity of the cyst to make a drainage. Efficiency of paracentetic treatment is usually low and pseudocysts are often formed.
In other cases various percutaneous drainings from nidi of infection are usually made. With patients having pseudocyst of the pancreas drainage № 8-12 Fr is performed (according to the technique of Seldinger). Also percutaneous draining with the use of drainages № 8-12 Fr is carried out with some patients with infected pseudocysts; the installation of two drainages at the top and bottom pole of the cyst with an active aspiration of the content is made with 4 of them. Telescopic tight bougieurage of the primary paracentetic canal to the calibre of the used drainage tube (8-11 mm) is made with some patients with pancreatogenic abscess.
With some groups of patients having pseudocysts of the pancreas LIM with installation of drainages are the most effective. The complete medical effect with patients with abscesses of the abdominal cavity attained more than 90 percent. Draining of nidi is the most effective in case of omentobursitis. Efficiency of a series of punctures, combination of punctures and drainages, installations of drainages under ultrasonic guidance is the subject for further improvement.