COMPARING VARIOUS METHODS OF SURGICAL TREATMENT OF FERMENTATION STAGE ACUTE DESTRUCTIVE PANCREATITIS
This article is dedicated to analysis of the results of treatment of 226 patients with Acute Destructive Pancreatitis (ADP), of which 58 patients in the fermentation stage (first 5 days upon illness onset) received conservative therapy, and 168 people underwent surgery. In the group of patients who underwent surgery, laparoscopic technique was applied to 102 patients, and 66 patients were operated with laparotomy access. Indications for surgical treatment in the early period of ADP were such as: diffuse peritonitis, severe endogenous intoxication in the presence of free fluid in the abdomen cavity and (or) in the saclesser omental sac and (or) in the supraperitoneal tissue; ADP being accompanied with acute cholecystitis, biliary hypertension. Use of laparoscopic techniques in the fermentation phase of acute destructive pancreatitis has evidently improved the outcomes of treatment: reduced frequency rate of septic complications affecting the pancreas and retroperitoneal fat, reduced inpatient term. However, despite the clear advantages of minimally invasive intervention, after laparoscopy we observed increase in the intensity of lipid peroxidation and decreased antioxidant protection that determines usefulness of application of antioxidant therapy in the immediate postoperative period.