Take Care of Your Pancreas!

At present the general approaches to diagnostics and treatment of various forms of acute pancreatitis (AP) are determined. They assume a complex conservative therapy of abortive AP and refusal from early open operations in case of sterile pancreatonecrosis.

Usually purulo-septic complications of pancreatonecrosis indicate that surgical treatment is needed, however the question of the proper sanation method (open surgical operation, beam diapeutics, endoscopy) is debatable. Also the question of expediency of surgical sanation of sterile pancreatonecrosis remains. It is because of the variety of clinicopathologic forms of destructive pancreatitis and disagreements in differentiation between “sterile” and “infected” forms of pancreatonecrosis. The fact is that their clinical and laboratory manifestations are often similar, and traditionall methods of instrumental diagnostics not always allow to determine exactly the development of the infection in the affected zones of the pancreas (P) and/or retroperitoneal tissue.

At present taking into account the probabilistic nature of noninvasive ultrasonic tomography (UST) in verification of pancreatonecrosis, the early and reliable detection of its aseptic and septic forms can be possible only in case of microscopic and microbiological investigation of the material taken by diagnostic puncture under ultrasonic guidance.

We have analyzed lots of literature and come to the conclusion that the question of timely diagnosis of pancreatonecrosis and justified use of drainage and other low-invasive surgical methods at different stages of disease development is very urgent.