ABSTRACT
The way of comprehensive treatment of acute destructive pancreatitis is worked out. The method is based on multicomponent sanitation of pancreatic region: decompression of the pancreas parenchyma is followed by the isolated dialysis of the upper pole of the gland.
Subject(s)
Decompression, Surgical , Pancreatitis, Acute Necrotizing/surgery , Humans , Laparotomy , Pancreatitis, Acute Necrotizing/mortality , Survival RateABSTRACT
Using polymer techniques (plastination), research was conducted on the corpses of 62 human subjects, both male and female, who died at the age of 40-60 and had no signs of pathology of the abdominal organs and of retroperitoneal space, and on 7 corpses of the subjects who died as a result of a total pancreonecrosis. In total slices 1 mm thick, cut in frontal, sagittal and horizontal planes, the profile areas of the pancreas and connective tissue structures, surrounding the organ, were measured, and their correlation was determined. It was demonstrated that the existence of a strongly pronounced cellular tissue space, totally surrounding the pancreas with the minimal thickness of 5 mm, creates topographic-anatomically substantiated possibilities for the development of rational operation accesses and regional sanative methods. An anatomically substantiated method of closed dialysis of a cellular tissue space of the pancreatic region in destructive forms of pancreatitis, was developed, including conducting the drainage tubes to the pancreas area from both sides through the space between retrotransversal and anterenal fascia, as well as drainages through the space between parietal peritoneum and retroperitoneal fascia on 2 levels by three drainage tubes. The method is tested on 32 patients. It is shown that the flowing drainage of the retroperitoneal space according to the close type in patients with pancreonecrosis, prevents the generalization of the process, accelerates the process of detoxication by 2.4 times and decreases the mortality rate of pancreonecrosis to 10%.
