ETIOPATHOGENESIS AND SURGICAL TREATMENT OF BILIARY PANCREATITIS. REVIEW

Abstract

Introduction: Biliary pancreatitis is one of the most common pathologies, which is an important problem of modern
surgery and has been on the rise over the past decades. One of the main etiological factors in the development of
pancreatitis are diseases of the extrahepatic biliary tract. Pancreatitis of biliary genesis accounts for 26% to 60% of cases of
acute inflammation of the pancreas. Chronicization of acute biliary pancreatitis reaches 43% of cases. The leading factors in
the pathogenesis of "biliary" pancreatitis are: violation of outflow through the extrahepatic biliary tract and the ductal system
of the pancreas, the occurrence of biliary-pancreatic reflux with the development of intraductal hypertension. Unfavorable
outcomes of acute pancreatitis do not tend to decrease and are observed in 30% of the number of hospitalized patients, in
80% of which, according to pathological anatomical autopsies, death is due to a severe form of the disease. The main peaks
of mortality in acute pancreatitis occur in two main phases - early, most often associated with the phenomena of
pancreatogenic shock, and late, due to infectious complications of destructive forms. Purulent complications of acute
pancreatitis are so diverse in form and localization that they require an almost individual approach to the treatment of each
individual patient.
Objective: To review the literature on the surgical treatment of biliary pancreatitis.
Research methods: Literature search was carried out in search engines: Pubmed, Google Academy, elibrary.ru, as well
as "manually". The search depth of Pubmed, Google Academy, elibrary.ru, as well as "manually", was not limited. The
following filters were applied: full text, humans. Criteria for inclusion of publications in the review: publications that are in fulltext access, in Russian and English, carrying statistically verified conclusions. Exclusion criteria: duplicate data, summaries
of reports, newspaper publications, personal communications.
Results: Unfavorable outcomes of acute pancreatitis do not tend to decrease and are observed in 30% of the number of
hospitalized patients, in 80% of which the fatal outcome according to pathological anatomical autopsies is due to a severe
form of the disease. The main peaks of mortality in acute pancreatitis occur in two main phases - early, most often
associated with the phenomena of pancreatogenic shock, and late, due to infectious complications of destructive forms.
Purulent complications of acute pancreatitis are so diverse in form and localization that they require an almost individual
approach to the treatment of each individual patient. Discussed and insufficiently unambiguous at the present time remains
surgical tactics for various forms of acute pancreatitis in etiology.
Conclusions: Thus, high prevalence rates, frequent complications of biliary pancreatitis, the presence of numerous risk
factors for its development necessitate the search for the most optimal methods for timely diagnosis and surgical treatment
of this disease.