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OPTIMIZATION OF ENDOSCOPIC TREATMENT METHODS IN
PATIENTS WITH ACUTE PANCREATITIS.
Khojimetov Davron Shukhratbekovich
Akbarov Farrux Saydaliyevich
Andijan State Medical Institute
https://doi.org/10.5281/zenodo.15104757
Relevance:
Acute pancreatitis (AP) is a serious pathology of the abdominal
organs, which to this day is one of the most important problems of emergency
abdominal surgery. Indeed, the incidence and consistently high mortality rates
are confirmed by the indicators. The etiological factors of pancreatitis are mainly
gallstone disease, alimentary tract, and alcoholism. Acute pancreatitis of biliary
etiology occurs in about 30-50% of cases in European and North American
countries, while the overall mortality rate is about 10% and has almost no
tendency to decrease. With destructive pancreatitis, pancreatic necrosis, it
reaches 75%.
Objective:
To optimize the use of retrograde endoscopic techniques to
reduce complications, mortality, and improve outcomes in patients with acute
pancreatitis.
Material and methods.
All patients with acute pancreatitis treated in the
surgical department of the 3rd clinic of the ADTI and the surgical departments of
the ASMSH from 2020 to 2024 participated in the study. All patients were
admitted to the emergency department as an emergency or transferred from
specialized departments with clinical manifestations of acute pancreatitis. The
majority of the study included patients aged 21 to 65 years. 100 men (43
percent), 100 women (57 percent). The average age of the patients was 44 +- 2.0
years. The patients were mainly divided into 2 groups. 36 patients in group 1
were treated retrospectively with standard conservative drugs. Group 2
included 32 patients who underwent endoscopic papillosphincterotomy and
stenting of the Wirsung tract in combination with the Santdart conservative
method.
Results and discussion.
The results of treatment of patients with pancreatitis and pancreatic
necrosis complicated by endoscopic methods of pancreatic duct decompression
depend on the nature of pancreatic necrosis and the time of onset of the disease.
In group I, patients were hospitalized in the late stages with various
complications after laparotomy, external drainage of the common bile duct, and
28% (10) of patients died, while in group II, patients underwent laparotomy,
endoscopic papillosphincterotomy and stenting of the Wirsung tract with the
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Santdart conservative method. Thus, based on the obtained data, in order to
accurately diagnose pancreatic necrosis, we recommend that abdominal
ultrasound and CT be performed in the first hours (initial 2-6 hours) of the
patient's hospitalization.
Conclusion:
Thus, endoscopic operations in patients with pancreatic
necrosis are performed as part of a complex of therapeutic interventions in
patients with pancreatic necrosis. They are performed early in the course of
pancreatic necrosis. The volume of endoscopic interventions depends on the
etiology of the disease, the state of the bile ducts and the pancreatic ducts
(Wirsung). In addition, the availability of trained doctors and specialized
hospital departments with experience in the treatment of patients with
pancreatic necrosis and endoscopic interventions in the bile ducts and
pancreatic ducts is of great importance in reducing the number of complications
of pancreatic necrosis and death, and endoscopic operations should be
performed by a qualified endoscopist.
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