milmedВоенная медицинаMilitary Medicine2074-5044Белорусский государственный медицинский университет10.51922/2074-5044.2023.3.87milmed-334Research ArticleОБЗОРЫ И ЛЕКЦИИREVIEWS AND LECTURESОстрый панкреатит билиарной этиологии. Сообщение 2. Современные принципы диагностики и леченияAcute pancreatitis of biliary etiology. Report 2. Current principles of diagnosis and treatmentМазаникА. В.MazanikA. V.

Минск

Государственное учреждение «432 ордена Красной Звезды главный военный клинический медицинский центр Вооруженных Сил Республики Беларусь»Belarus202329082026038794Copyright © Мазаник А.В., 20262026Мазаник А.В.Mazanik A.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://milmed.ejournal.by/jour/article/view/334

Представлены принципы диагностики и лечения, основанные на международных доказательных практических рекомендациях.

Особенности патогенеза заболевания диктуют необходимость выделения острого панкреатита билиарной этиологии в отдельную клиническую категорию и определяют существенные различия в тактике его лечения относительно острого панкреатита иной этиологии. Ключевыми компонентами комплексного лечения острого панкреатита билиарной этиологии являются купирование (консервативное или оперативное) протоковой гипертензии и холецистэктомия, предпочтительно – лапароскопическая, при этом период времени, когда декомпрессия протоковой системы может предотвратить прогрессирование острого панкретита, не превышает 48 ч после начала заболевания. Патогенетически обоснованным методом выбора окончательного лечения острого панкреатита билиарной этиологии является ранняя лапароскопическая холецистэктомия. Лапароскопическая холецистэктомия должна выполняться в период текущей госпитализации независимо от тяжести заболевания всем больным, как только их состояние позволит перенести вмешательство.

Principles of diagnostics and treatment based on the international proved practical recommendations are presented.

The peculiarities of the pathogenesis of the disease dictate the necessity of distinguishing acute biliary pancreatitis into a separate clinical category and determine essential differences in its treatment tactics in comparison with acute pancreatitis of other etiology. The key components of the complex treatment of acute biliary pancreatitis are curing (conservative or operative) of duct hypertension and cholecystectomy, preferably – laparoscopic, and the time period, when duct system decompression can prevent the progression of acute pancreatitis, does not exceed 48 hours after the disease beginning. Early laparoscopic cholecystectomy is a pathogenetically grounded method of the final treatment of acute pancreatitis of biliary etiology. Laparoscopic cholecystectomy should be performed during current hospitalization irrespective of the disease severity in all patients as soon as their condition allows to survive the intervention.

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The authors declare that there are no conflicts of interest present.