Diagnosis and treatment of pancreatic peritonitis
Sovliov, S.A.; Strunina, O.A.
Khirurgiia 11: 39-43
2001
ISSN/ISBN: 0023-1207 PMID: 11764582 Document Number: 528074
Results of diagnosis and treatment of 71 patients with general pancreatogenic peritonitis (7.3% of all patients with general peritonitis) are analyzed. The main diagnostic methods were ultrasound (100% cases), computed tomography (29.5%), laparoscopy (60%). Based on clinical, instrumental, bacteriologic and morphologic examinations primary and secondary pancreatogenic peritonitis are distinguished. Optimal policy of treatment depended on peritonitis forms. In primary (enzyme peritonitis) minimally invasive methods of treatment were used: laparoscopic drainage of abdominal cavity and bursa omentalis, therapeutic blockades etc. in secondary (bacterial) peritonitis wide laparotomy with sanations of abdominal cavity and minor bursa omentalis were used. Consecutive necrectomies and sequestrectomies were preferred (70.2%). Advantages of hemofiltration over other methods of efferent therapy are demonstrated. The above methods of treatment permitted to decrease postoperative lethality in secondary purulent pancreatogenic peritonitis from 68 to 44%.