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TREATMENT OF SEVERE FORM OF “ACUTE PANCREATITIS”

The clinical approach with acute pancreatitis is controversial. Generally, it is accepted concervative treatment of the acute edematosic pancreatitis and operative treatment of the infected pancreatic necrosis. Within this frame is the field of discussion of different therapeutic approcaches. The acute pancreatitis manifests itself with differentl clinical models from light to severe necrotizing disorder with local and systematic complications. The acute pancreatitis involves systematic immuno- inflammatory response to a local process of self-digestion of the pancreatic gland with various involvement of peri-pancreatic tissue and remote organs and systems. The overconsumption of alcohol with men and gallstone disease with women are the most popular cause of acute pancreatitis. The main pathologic processes with acute pancreatitis are the inflammation, edema and necrosis of pancreatic tissue as well as the inflammation and injury of extrapancreatic organs. The acute pancreatitis occurs in two forms as they are diagnosed when the patient is hospitalized and they are evaluated in the process of treatment in progress. The foundation of the correspondent treatment is the accurate diagnostic evaluation of the types of pancratiitis in two aspects – clinnical (light, severe acute pancreatitis) and morphologic (edematous, necrotic). The conservative treatment of acute pancreatitis is the main one, the operative intervention is used with patients with acute pancreatitis – it is not shown for severe acute pancreatitis with sterile pancreatic necrosis, as it is admissible in a limited number of cases. The severe acute pancreatitis with infectous pancreatic necrosis is an indicator for operative intervention. Regardless of the bacterial status of pancreatic necrosis, operative treatment should be initiated in a later stage of the disorder.