Indications to surgical treatment in patients with infected pancreonecrosis

Abstract

Objective: to determine the prognostic value of the complex assessment of the patient's condition (clinical examination using scales, biochemical markers, dynamic ultrasound and CT) for the timely formulation of indications for surgery in the development of purulent complications of pancreatonecrosis in the phase of septic sequestration. Material and Methods: the study included 186 patients with pancreatic necrosis. The comparison group included patients whose manifestations of the disease were limited to the development of enzymatic peritonitis. The second group includes patients who have formed peripancreatic infiltrate and (or) isolated pancreatogenic abscess. The third group consisted of patients with purulent-necrotic parapancreatitis. Results: Measurements on the SAPS III scale revealed a significant difference of scores in patients with purulent necrotic parapancreatitis and patients in the comparison group. Similar data were obtained from a comparative assessment of the severity of organ failure on the SOFA scale. The study showed a significant decrease in the serum albumin level in patients with purulent-necrotic parapancreatitis and the presence of a significant difference in this parameter with patients in the comparison group. Conclusion: With purulent-necrotic parapancreatitis, a complex assessment of the patient's condition helps timely recognize infectious complications and formulate the indications for surgical intervention. In patients with limited infected pancreatic necrosis, the use of scales and biochemical markers was not very informative.