OBJECTIVE

To improve treatment outcomes in patients with acute severe pancreatitis by using of complex staged surgical treatment based on minimally invasive techniques in multi-field emergency hospital.

MATERIAL AND METHODS

The study enrolled 343 patients with acute pancreatitis (mild — 123 (35.9%) patients, moderate — 119 (34.7%) patients, severe — 101 (29.4%) patients). Seventy-one (70.3%) patients had severe alimentary pancreatitis, 29 (28.7%) — biliary pancreatitis, 1 (1.0%) — traumatic pancreatitis. Mean hospital-stay in patients with severe acute pancreatitis was 23.0 [1; 115] days.

RESULTS

Organizational measures, reorganization of hospital management structure, changes in methodological principles and personnel of surgical department are described. Minimally invasive percutaneous, transluminal, laparoscopic and traditional surgical interventions were performed in 52 (51.5%) patients with severe pancreatitis. Sequestrectomy was performed in 19 (36.5%) patients (percutaneous — 14 (26.9%), transluminal — 5 (9.6%)). Mortality rate without surgery was 18.4% (n=9), after minimally invasive sequestrectomy— 31.1% (n=5).

CONCLUSION

There were better postoperative outcomes in patients with acute severe pancreatitis in multi-field emergency hospital after organizational restructuring of hospital, changes in medical personnel training and equipment. Optimized interdisciplinary interaction in multidisciplinary approach to acute severe pancreatitis was effectively achieved through higher versatility of all surgeons to multifunctional specialists.