scholarly journals Surgical treatment and complications of operations in acute pancreatitis severe

2018 ◽  
Vol 5 (4) ◽  
pp. 72-81
Author(s):  
I. A. Kaprin ◽  
Z. E. Eldarova ◽  
V. P. Glabai
Keyword(s):  
Acute Pancreatitis ◽  
Surgical Treatment ◽  
Pancreatic Necrosis ◽  
Necrotic Lesion ◽  
Controversial Issues ◽  
Early Complications ◽  
Surgical Interventions ◽  
Modern Classification ◽  
Abdominal Compartment

In this reviewing article there are discussed such topics as modern classification of acute pancreatitis, indications for surgical treatment of severe and, first of all, infected pancreatic necrosis, modern tendencies in this problem and controversial issues of it. The analysis of two different methods of surgeries («closed» and «open») for drainage of retroperitoneal space depending on the scale of necrotic lesion has been carried out. The perspective use of the natural transluminal endoscopic surgery (ENOTES) in the treatment of acute pancreatitis, complicated by abdominal compartment syndrome, is shown. The frequency of intraoperative and early complications after «closed» and «open» surgical interventions for severe acute pancreatitis has been reviewed; also recognition of the complications, the prevention of their occurrence and the choice of surgical or conservative methods of treating the complications.

OPTIMIZATION OF SURGICAL TREATMENT OF PATIENTS WITH ACUTE PANCREATITIS USING MINIINVASIVE TECHNIQUES

2020 ◽  
pp. 16-18
Author(s):  
A. G. Drozdova
Keyword(s):  
Acute Pancreatitis ◽  
Surgical Treatment ◽  
Minimally Invasive ◽  
Pancreatic Necrosis ◽  
Minimal Invasive ◽  
Hospital Treatment ◽  
Bed Days ◽  
Minimal Invasive Techniques ◽  
Invasive Techniques

Summary. The aim of the study. To improve the results of surgical treatment of patients with acute pancreatitis using minimal invasive techniques. Matherials and Methods of the study. The results of surgical treatment of 75 patients with different forms of acute pancreatitis were analyzed. All patients were examined and operated on. Results of the study. Minimally invasive interventions were performed in 92 % of the analyzed patients. Intraoperatively acute pancreatic edema was observed in 43 % of patients, hemorrhagic pancreatic necrosis – in 24 %, infected pancreatic necrosis – in 33 %. The postoperative period was complicated by 13.3 %, the mortality rate was 9.3 %. Conclusions. The use of minimally invasive techniques for treating acute pancreatitis can significantly improve the results of surgical treatment of patients with this pathology. The frequency of complications and lethality decreases. Also, it is possible to significantly reduce operational trauma, and hence the number of bed-days of stay in hospital treatment. This contributes to reducing the financial cost of treatment in patients with acute pancreatitis, as well as improving the quality of life of this category of patients.

scholarly journals Specific features of anesthesia in patients with myasthenia gravis

2016 ◽  
Vol 69 (9-10) ◽  
pp. 305-311
Author(s):  
Ivana Spasojevic ◽  
Danica Hajdukovic ◽  
Milena Komarcevic ◽  
Stanislava Petrovic ◽  
Jelena Jovanovic ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Conservative Treatment ◽  
Myasthenia Gravis ◽  
Nicotinic Acetylcholine Receptors ◽  
Acetylcholine Receptors ◽  
Surgical Interventions ◽  
Different Types ◽  
Increased Sensitivity ◽  
Tensilon Test

Introduction. Myasthenia gravis is an autoimmune disease caused by antibodies leading to the destruction of nicotinic acetylcholine receptors on the neuromuscular junction. It is characterized by muscle weakness that gets aggravated with physical activity and improves at rest. Myasthenia Gravis Foundation of America made the clinical classification of Myasthenia gravis which is still in use today. ?Tensilon test? is still the gold standard for the diagnosis of Myasthenia gravis. In addition to this test repeated muscular stimulation can be used as well as the analysis of specific autoantibodies. Treatment of Myasthenia Gravis. In conservative treatment of Mysthenia gravis anticholinesterases, immunosuppressants and plasmapheresis can be used. If conservative treatment does not lead to the desired remission, surgical treatment is indicated. The most accepted indication for thymectomy is the presence of thymoma with generalized form of Myasthenia gravis in adults. How to Distinguish Myasthenic From Cholinergic Crisis. The following is important to make a difference between these two crises: knowledge of the events that preceded the crisis, the size of pupils as well as the presence of muscarinic signs and tensilon test. Specific Features of Anesthesia in Patients with Myasthenia Gravis. Mechanism of the disease development is the reason for the increased sensitivity or resistance of these patients to certain types of drugs used in anesthesia. Protocol of Perioperative Anesthesia in Patients with Myasthenia Gravis. Based on 35 years of experience in the surgical treatment of patients with Myasthenia gravis anesthesiologists at the Department of Thoracic Surgery, Institute for Pulmonary Diseases of Vojvodina, made the protocol of anesthesia and perioperative treatment for these patients. Conclusion. Anesthesiologists may have to deal with a patient with myasthenia gravis in different types of surgical interventions. The protocol for anesthesia and perioperative management of these patients herewith presented may greatly help them in their clinical practice.

scholarly journals Acute necrotising pancreatitis - causes of deaths: single-centre retrospective study

2019 ◽  
Vol 12 (1) ◽  
pp. 29-37
Author(s):  
Denis Vladimirovich Mizgirev ◽  
Valeriy Vladimirovich Kremlev ◽  
Lyudmila Aleksandrovna Neledova ◽  
Victor Nikolaevich Pozdeev ◽  
Anastasiya Andriyanovna Katysheva ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Minimally Invasive ◽  
Pancreatic Necrosis ◽  
Abdominal Cavity ◽  
Infectious Complications ◽  
Endotoxin Shock ◽  
Invasive Treatment ◽  
Surgical Interventions ◽  
Late Mortality ◽  
Causes Of Deaths

Relevance. There is a discussion about the prevalence of early or late mortality and the main causes of death in different phases of acute pancreatitis. Analysis of mortality is important for the determination of ways to improve the results of treatment of pancreatic necrosis. Aim of the research is analysis of the structure, timing characteristics and causes of deaths in pancreatic necrosis, the effect of the configuration of parapancreatitis and surgical tactics on the outcome of the disease. Materials and methods. Retrospective single-center study of lethal outcomes in acute pancreatitis was performed, the structure of mortality, cases of discrepancies in diagnoses, the timing of the onset and causes of deaths of patients were studied. The lethal outcomes were compared in the operated patients, the frequency of the mesentery root involvement, the indications and the timing of the interventions were assessed. Results. The ratio of early and late mortality was 45,2% to 54,8%, respectively. The main causes of early mortality – endotoxin shock and multi-organ failure, late one – infectious complications. In 9,6% of the patients, the diagnosis was made only with an autopsy. The prognostic value of the SOFA and SAPS II scales is characterized as low. The tactics of surgical treatment has changed in favour of minimally invasive surgery. The average conversion time for ineffective percutaneous procedures was 21,4 days. The involvement of mesentery in parapancreatitis was often accompanied by a breakthrough of the abscess into the abdominal cavity. Conclusion. The surgical component of the reduction in mortality is the rejection of unreasonable surgical interventions, the earlier conversion to "traditional" operations in case of ineffective minimally invasive treatment and the allocation of "central" localization of parapancreatitis as a serious prognostic factor of the course of severe pancreatitis.

scholarly journals OPTIMIZATION OF SURGICAL TREATMENT OF PATIENTS WITH ACUTE PANCREATITIS USING MINIINVASIVE TECHNIQUES

2019 ◽  
pp. 63-65
Author(s):  
A. G. Drozdova
Keyword(s):  
Acute Pancreatitis ◽  
Surgical Treatment ◽  
Minimally Invasive ◽  
Pancreatic Necrosis ◽  
Minimal Invasive ◽  
Hospital Treatment ◽  
Bed Days ◽  
Minimal Invasive Techniques ◽  
Invasive Techniques

Abstract. The aim of the study. To improve the results of surgical treatment of patients with acute pancreatitis using minimal invasive techniques. Matherials and Methods of the study. The results of surgical treatment of 75 patients with different forms of acute pancreatitis were analyzed. All patients were examined and operated on. Results of the study. Minimally invasive interventions were performed in 92% of the analyzed patients. Intraoperatively acute pancreatic edema was observed in 43% of patients, hemorrhagic pancreatic necrosis – in 24%, infected pancreatic necrosis – in 33%. The postoperative period was complicated by 13.3%, the mortality rate was 9.3%. Conclusions. The use of minimally invasive techniques for treating acute pancreatitis can significantly improve the results of surgical treatment of patients with this pathology. The frequency of complications and lethality decreases. Also, it is possible to significantly reduce operational trauma, and hence the number of bed-days of stay in hospital treatment. This contributes to reducing the financial cost of treatment in patients with acute pancreatitis, as well as improving the quality of life of this category of patients.

scholarly journals HOW TO AVOID MEDICAL ERRORS IN SURGERY?

2020 ◽  
Vol 75 (3) ◽  
pp. 13-19
Author(s):  
V.A. Gol′brah ◽  
◽  
S.S. Maskin ◽  
V.V. Matyukhin ◽  
◽  
...  
Keyword(s):  
Medical Errors ◽  
Surgical Interventions ◽  
Widespread Adoption ◽  
Parallel Increase ◽  
Modern Classification ◽  
Legal Foundations ◽  
Modern Technologies ◽  
Unexpected Consequences

The enchantment of numbers of surgical interventions and the widespread adoption of modern technologies, lead to a parallel increase in technological errors and morbidity in recent years. This article analyzes such section of surgery as «medical errors», provides a modern classification of medical errors and complications according to foreign and Russian authors. The article contains information about definition, legal foundations and principles for the prevention of unexpected consequences of surgical interventions

scholarly journals Successful surgical treatment of abdominal compartment syndrome in patient with pancreatic necrosis

2018 ◽  
Vol 23 (2) ◽  
pp. 119-124
Author(s):  
S. G. Shapovaliyants ◽  
A. G. Pankov ◽  
A. I. Mikhalev ◽  
T. I. Gerasimov
Keyword(s):  
Case Report ◽  
Surgical Treatment ◽  
Compartment Syndrome ◽  
Pancreatic Necrosis ◽  
Clinical Effect ◽  
Abdominal Pressure ◽  
Minimally Invasive Procedures ◽  
Invasive Procedures ◽  
Linea Alba ◽  
Abdominal Compartment

Case report of patient with severe autonomous advanced pancreatic necrosis followed by compartment syndrome is presented. Augmentation of intra-abdominal pressure from 18 to 30 mm Hgwas accompanied by aggravation of respiratory, renal and intestinal insufficiency. Urgent video-assisted fasciotomy was applied with dissection of linea alba while peritoneum was preserved. Postoperative period was characterized by reduced intra-abdominal pressure followed by its normalization after 24 hours. Favorable clinical effect was achieved. Subsequent medication was able to avoid surgery and minimally invasive procedures. Patient was discharged after 28 days.

scholarly journals MULTIMODAL REHABILITATION OF PATIENTS OPERATED ON FOR PANCREATIC NECROSIS

2021 ◽  
pp. 36-39
Author(s):  
I. A. Kryvoruchko ◽  
K. Yu. Parkhomenko ◽  
A. G. Drozdova ◽  
V. A. Vovk ◽  
K. E. Payunov ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Fast Track ◽  
Pancreatic Necrosis ◽  
Fast Track Surgery ◽  
Surgical Interventions ◽  
Surgical Department ◽  
Results Of Treatment ◽  
Financial Costs ◽  
Commercial Enterprise ◽  
Bed Days

Summary. The aim of the study — to improve the results of surgical treatment of patients operated on for pancreatic necrosis. Matherials and Methods of the study. The results of treatment of 56 patients operated on for pancreatic necrosis who were treated in the surgical department of the Municipal non-commercial enterprise of the Kharkov regional council «Regional Clinical Hospital» from 2018 to 2020, aged 22 to 69, were analyzed. In the treatment of all patients, a “step-up approach” tacktics was used and the principles of the concept of “fast-track surgery” or multimodal rehabilitation of patients after surgery were implemented. Results of the study. Along with the performed surgical interventions (mostly minimally invasive), a “staged” method of managing the postoperative period in patients operated on for pancreatic necrosis is proposed and implemented. As a result, there is a decrease in the incidence of postoperative complications and a decrease in the length of stay in the surgical department (14.6 bed-days). Conclusions. This example confirms the appropriateness of applying the principles of “fast-track surgery” in everyday surgical practice in the complex treatment of patients with pancreatic necrosis, as the results of surgical treatment of this category of patients are improved and financial costs for treatment are reduced.

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