RESUMO
In 2015 yr еndoscopic transpapillary interventions (ÐТI), performed for diseases of the hepatopancreatoduodenal zone organs, were done in 697 patients. In 315 (45.2%) of them ÐТI were diagnostic, in 382 (54.8%) performed with treatment objective. Ðеdicinal support for the ÐТI conduction in 631 (90.5%) patients have included conduction of superficial sedation and local anesthesia of pharynx. Ðnesthesiological support was applied in 66 (9.5%) patients, including total intravenous anesthesia in 11 (16.6%), еndotracheal narcosis in 55 (83.4%). Using of general anesthesia in comparison to superficial sedation creates more favorable conditions for the ÐТI performance, what have permitted to reduce their duration and complications rate twice.
Assuntos
Analgésicos Opioides/uso terapêutico , Anestesia Geral/métodos , Coledocolitíase/cirurgia , Relaxantes Musculares Centrais/uso terapêutico , Pancreatite/cirurgia , Adulto , Anestesia por Condução/métodos , Anestesia Endotraqueal/métodos , Anestesia Intravenosa/métodos , Anestesia Local/métodos , Coledocolitíase/patologia , Duodeno/patologia , Duodeno/cirurgia , Endoscopia do Sistema Digestório , Feminino , Humanos , Fígado/patologia , Fígado/cirurgia , Masculino , Pessoa de Meia-Idade , Pâncreas/patologia , Pâncreas/cirurgia , Pancreatite/patologia , Estudos Retrospectivos , Resultado do TratamentoRESUMO
Combined method of laparoscopically and retroperitoneoscopically assisted necrsequestrectomy, consisting of staged application of miniinvasive methods with simultaneous laparoscopic and retroperitoneoscopic control of necrsequestrectomy, was elaborated with the objective to improve surgical treatment of an acute pancreatitits. The procedure has significant advantages over open operative intervention in purulent complications of necrotic purulent pancreatitis: reduction of the local and systemic operative treatment severity, minimization of microbial metabolites coming into the blood, total visual control of intervention, reduction of the vascular injuries risk, аdequate surgical sanation with saving of viable pancreatic parenchyma, absence of conditions for the purulent complications occurrence while the operative wound healing is going on, preservation of possibility for an adequate draining, using drains of a large diameter.