Острый панкреатит билиарной этиологии. Сообщение 2. Современные принципы диагностики и лечения

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.

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