On the issue of surgical tactics in acute pancreatitis

Dissatisfaction with the final results of treatment of patients with acute pancreatitis prompts the search for new methods of diagnosis and therapy of this disease. Having experience in surgical treatment of 201 patients with various forms of pancreatic necrosis, we came to the conclusion that the classification should reflect the state of the parapancreatic cellular space. This is due to the following points. First, an extensive purulent-necrotic lesion of the retroperitoneal tissue is considered one of the main reasons for the development of the syndrome of endogenous intoxication, leading to plurivisceral syndrome, which in some cases is fatal. Secondly, the widespread inflammatory infiltrate of the parapancreatic space can have a favorable (resorption) and unfavorable (abscess formation) course, which requires the doctor to carry out timely diagnostic measures to verify the complications of the postoperative period. Thirdly, a purulent or infiltrative (in the form of a dense infiltrate) lesion can determine the volume of surgical intervention.