Using modified drainage device in the treatment of infected pancreatic necrosis

Abstract

Background. In recent years, the problem of pancreatic necrosis in urgent surgery has been at the forefront. Infected pancreatic necrosis (IPN) occurs in 38–69 % of patients with severe acute pancreatitis, mortality in this pathology reaches 8–49 %. The aim of the work – to increase the efficiency of treatment of patients with infected pancreatic necrosis and acute destructive pancreatitis by using an original drainage device. Materials and methods. The analysis of the results of treatment of 102 patients with IPN, who underwent different types of operations, depending on the prevalence of the process, was carried out. Women were 29 (28.4 %), men – 73 (71.6 %), aged from 27 to 74 years. We used traditional methods of patient examination. Two groups were formed. The 1st group (main) consisted of 43 (42.1 %) patients, in whom the traditional complex of therapeutic and diagnostic measures was used in combination with the developed “drainage device”. 59 (57.9 %) patients of the 2nd group (control) underwent standard medical and diagnostic practice. Results. A total of 102 patients underwent 186 operations: 96 - minimally invasive and 90 – by the traditional “open” method. The number of postoperative complications in the 1st group of patients was 8 (7.8 %), in the 2nd group – 18 (17.6 %) with a mortality rate of 5 (11.6 %) and 16 (27.1 %), respectively. The most common cause of death was sepsis with multiple organ failure. Conclusions. It is necessary to combine minimally invasive and “open” operations for infected pancreatic necrosis against the background of complex therapy. In 23.4 % of patients, minimally invasive technologies are the final method of treatment. The use of the developed “drainage device” leads to a significant reduction in complications and mortality.

Keywords

• infected pancreatic necrosis
• treatment
• operations
• drainage device