| 摘要 |
The invention refers to medicine, particularly to surgery and can be used for endoscopic treatment of biliary destructive acute pancreatitis. Summary of the invention consists in that it is carried out the infusion, desintoxicating, antibacterial, symptomatic therapy and using antienzymes. It is carried out the fibrogastroduodenoscopy, it is determined the state of Vater's ampulla, of biliary tracts and of Wirsung's duct, it is carried out the endoscopic papillosphincterotomy, drainage of Wirsung's duct with intraductal administration of the pancreas secretory function inhibitors. Within 24...48 hours it is carried out the laparoscopic cholecystectomy with drainage of choledoch through the stump of the cystic duct, it is removed the exudate from the parapancreatic space and omental bursa through mesocolon, it is drained the abdominal cavity by carrying out the intra- and postoperative lavage. In 6...7 days it is removed the drain from the choledoch. Within 9...15 days after disappearance of the acute inflammation symptoms it is carried out the laparoscopic necrosectomy in the region of head and of pancreas body through mesocolon, and in 3...4 days from the last intervention it is carried out the laparoscopic necrosectomy in the caudal region and the region of body through the gastrocolic ligament, after each necrosectomy being carried out lavage with drainage of the parapancreatic space, the omental bursa and the abdominal cavity.
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