Planned endoscopic examination of the abdomen for pancreatic necrosis and advanced peritonitis / Монголын Анагаах Ухаан

ABSTRACT

Introduction@#We classify peritonitis as end-stage if it lasts for more than 72 hours or more than three days. At this point, the pleural effusion of the posterior abdominal wall, the pleural layer of the gastrointestinal tract, and the dimples of the esophagus are all scattered with pus. During the first operation, it is very difficult to completely cleanse these abscesses. After the operation, pus will collect in the abdomen and abscesses will form, which will require another operation. If this postoperative complication is not diagnosed in time and operated again (relaparotomy), many other complications can occur and the risk of death is high. 48-hour relaparotomy mortality is higher than early surgery (21.8% -76.8%). Necrotic pancreatitis is chronic peritonitis (an abscess of the lower extremities) in which only non-pancreatic adipose tissue, sebum glands, pericardial effusions, pericardial effusions, and kidney adipose tissue become necrotic.@*Purpose@#Endoscopic surveillance for chronic pleurisy with pancreatic necrosis@*Objectives@#</br> 1. Endoscopic monitoring of the postoperative course of pancreatic necrosis.</br> 2. Calculate the results of washing and cleaning using binoculars.@*Method@#Patients with advanced peritoneal inflammation and necrotizing pancreatitis should be selected for reoperation. After removing the dead pancreatic tissue (necrosectomy), all layers of the abdomen are temporarily closed. A 6 mm short tube with surgical rubber is cut into the small pancreas, inserted 2 cm deep into the standard abdomen and sutured to the skin. Or use a silicone tube 4 - 5 cm long.@*Result@#The study was carried out on 56 patients in 2016-2020. The mean age was 50 (89%) for men, 6 (11%) for women, and 47.5 ± 8.6.@*Conclusion@#</br> 1. Endoscopic follow-up showed 19 (76%) persistent postoperative peritonitis and re-clearance, and 6 (24%) patients were not diagnosed with persistent peritonitis.</br> 2. 25 (50%) cases of persistent peritonitis after surgery were washed 1-3 times. This method has proven to be a safe and easy procedure and can be used in any urban or rural hospital.