CHRONIC BILIARY PANCREATITIS: ETIOLOGY, PATHOGENESIS, CLINICS, TREATMENT

N.B. GUBERGRITS, O.A. BONDARENKO

National Medical University n.a. M. Gorky, Donetsk, UKRAINE

National Medical University n.a. D. Galitsky, Lviv, UKRAINE

The frequency of chronic biliary pancreatitis ranges from 5% to 40–60% according to data of different authors. The disease develops as a result of gallstone disease, gallbladder and Oddi sphincter cholesterosis, acalculous cholecystitis. The most common cause of biliary pancreatitis is gallstone disease. The risk of pancreatitis is higher if gallstones are small and especially in cases of biliary sludge. When sludge crystals are passing through area of papilla of Vater the dysfunction of Oddi sphincter, then papillitis and even papillostenosis develop, which lead to pancreatitis. The basic mechanisms of biliary pancreatitis pathogenesis are biliopancreatic reflux and ductal pancreatic hypertension.

Pain and dyspeptic syndromes, manifestations of exocrine and endocrine pancreatic insufficiency, biliary hypertension dominate in the clinical picture.

Treatment includes cholecystectomy in time and, if it is necessary, endoscopic treatment. Conservative treatment of Oddi sphincter dysfunction includes antispasmodics, enzyme replacement therapy, antibacterial drugs. Special place in the treatment takes ursodeoxycholic acid, which stimulates the external secretion of pancreas and reduces the recurrence rate of biliary pancreatitis.

NEUTRALIZATION OF SKOLEX ON THE SURGICAL TREATMENT OF THE CHILDREN'S HYDATID DISEASE OF LIVER

CH.B. GULIYEV, R.SH. POLUKHOV, L.O. ZEYNIYEV, M.Q. BAGIROV

Azerbaijan Medical University, Baku, AZERBAIJAN

One of the important moments of echinococcectomy operation is the neutralization of the skolex. Our clinical has the quite experience on the neutralziaiton of the skolex during the open operations and the neutralization was carried out through Ion -iodine solutions (Iodine-fixanol % 1, Povidan-iodine % 2) on 198 patients, the relapse was not stated. Because of the impossibility of the isolation of the tissues around the cyst during laparoscopic echinococcectomy in difference with the open operation, the dissemination danger regarding with the pouring of the echinococ solution to the abdomen is high during the puncture. In order to prevent the dissemination, the necessity of the application of the antiparasitic solution to the parasitic field, before the puncture, arises. From this point of view, in order to reduce the absorption possibility of the antiparasitic solution, pouring around the cavity during laparoscopic echinococcectomy, the use of the iodine products in lower consistency is reasonable. Taking it into consideration, while studying of the effect of the various antiparasitic medicines within the experiment, we determine that sodium chloride 20% and diluted Povidon iodine solution 0.5% have the high antiskolex effect and absorption possibility of the Iodine ions of this consistency, is low. In order to carry out the neutralization during the ectomy of the hepatic laparoscopic echinococcectomy on 5 patients, we use sodium chloride 20% and diluted Povidon iodine solution 0.5%. Close postoperative and further complication is not stated.

We consider that sodium chloride 20% and diluted Povidon iodine solution 0.5% may-use as the antiparasitic medicines during the laparoscopic treatment of the hepatic echinococcus.

Date: 2014-12-28; view: 1098