RELEVANCE OF PREVENTION OF THE INFECTIOUS COMPLICATIONS IN ACUTE PANCREATITIS
The failed outcomes of infected necrotizing pancreatitis treatment make the prevention of infectious complications particularly relevance. Despite the objective benefits of non-surgical management in patients with sterile pancreatic necrosis, pharmacologic therapies facilities in the early period of the disease remain limited. Concordantly to available evidence the efficiency of fluid resuscitation, anticoagulants, antioxidants, epidural blockade, hyperbaric oxygen therapy, antisecretory agents, protease inhibitors, antibiotics, immunomodulators, enteral nutrition and minimally invasive surgical approaches to prevent infectious complications in predicted severe acute pancreatitis is considered in this review. Preventive strategies for septic complications of acute necrotizing pancreatitis such as intravenous fluid resuscitation, use of anticoagulants, epidural analgesia and early enteral feeding the evidence is strong. Advantages of enteral nutrition cannot be overemphasized from the standpoint of the trigger role of intestinal contents in the pathogenesis of pancreatogenic infection, as well as the level of evidence of relevant clinical studies.