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Journal of Gastronenterology and Digestive Diseases
|
Volume 3
J u n e 2 5 - 2 6 , 2 0 1 8 | D u b l i n , I r e l a n d
GASTROENTEROLOGY
International Conference on
MINIMALLY INVASIVE AND ENDOSCOPIC METHODS OF
TREATMENT OF POST-NECROTIC PSEUDOCYSTS OF
PANCREAS
Nazar Omelchuk
Ivano-Frankivsk National Medical University, Ukraine
Statement of the Problem:
Acute necrotic pancreatitis (ANP) remains complicated problem of urgent surgery because of high
frequency of systemic, purulent and septic complications, mortality rate, which is in patients with infected pancreonecrosis 14,7
– 26,4 %.
The Purpose:
The purpose of this study is to evaluate efficiency and establish indications for minimally invasive methods of
treatment of post-necrotic pseudocysts of pancreas.
Methodology &Theoretical Orientation:
For diagnostics we used ultrasonography, diagnostic laparoscopy, helical CTwith contrast
strengthening. Endoscopic interventions were applied by duodenoscopes Olympus under control of x-ray machine siemens BV
300. Cystodigestive fistulas were created by prickly papilotoms. For providing of long passability of cystodigestive fistula we used
two endoprostheses pig tail sized 10 Fr with length 5–6 sm. For transpapillary drainage we used pancreatic endoprostheses like
pig tail, sized 5–7 Fr with length 5 sm.
Findings:
In 62 (68,2%) patients were applied minimally invasive methods of treatment. Percutaneous external drainage in 33
(53,2 %) patients, endoscopic transmural drainage of post-necrotic pseudocysts in 11 (17,7%) patients. Combined endoscopic
interventions were applied in 18 (29,1%) patients. Endoscopic transmural drainage with temporary stenting of pancreatic duct in
11 (61,1%) patients, endobiliary stenting with temporary stenting of pancreatic duct in 3 (16,67%) patients, temporary stenting of
pancreatic duct in 3 (16,67%) patients, endoscopic transmural drainage with percutaneous external drainage in 1 (5,56%) patient.
Conclusion&Significance:
Usageof combinedminimally invasivemethods of treatment of acutenecrotic pancreatitis complicated
by postnecrotic pseudocysts help to improve results of treatment, reduction of complications amount, contraction of stationary
treatment terms and improving of life quality.
dr.nazaromelchuk@gmail.comJ Gastroenterol Dig Dis 2018, Volume 3