hepatoАнналы хирургической гепатологииAnnaly khirurgicheskoy gepatologii = Annals of HPB Surgery1995-54642408-9524НЭИКОН ИСП10.16931/1995-5464.2020169-78hepato-604Research ArticleОБЗОР ЛИТЕРАТУРЫREVIEWSСовременные технологии лечения инфицированного панкреонекроза: дифференцированный подходAdvanced technologies for treatment of infected pancreatic necrosis: differentiated approachhttps://orcid.org/0000-0002-6359-0998ГаллямовЭ. А.GallyamovE. A.

доктор мед. наук, профессор, заведующий кафедрой общей хирургии

119146, Москва, ул. Большая Пироговская, д. 19, стр. 1, Российская Федерация

Doct. of Sci. (Med.), Professor, Head of the General Surgery Department

19/1, Bolshaya Pirogovskaya str., Moscow, 119146, Russian Federation

gal_svetlana@mail.ruhttps://orcid.org/0000-0002-6569-7078АгаповМ. А.AgapovM. A.

доктор мед. наук, профессор, профессор кафедры хирургии

119991, Москва, ул. Ленинские Горы, д. 1, Российская Федерация

Doct. of Sci. (Med.), Professor of the Department of Surgery

1, Leninskie Gory str., Moscow, 119991, Russian Federation

getinfo911@mail.ruhttps://orcid.org/0000-0002-8092-0573ЛуцевичО. Э.LutsevichO. E.

доктор мед. наук, профессор, заведующий кафедрой факультетской хирургии №1

127473, Москва, ул. Делегатская, д. 20/1, Российская Федерация

Doct. of Sci. (Med.), Professor, Head of the Faculty Surgery Department

20/1, Delegatskaya str., Moscow, 127473, Russian Federation

oleglutsevich@gmail.comhttps://orcid.org/0000-0003-0352-2317КакоткинВ. В.KakotkinV. V.

Какоткин Виктор Викторович – клинический ординатор отделения хирургии №1 медицинского научно-образовательного центра

119192, Москва, Ломоно совский проспект, д. 27, корп. 10, Российская Федерация

Тел.: 8-985-100-07-94

Viktor V. Kakotkin – Resident of the Department of Surgery №1

Lomonosovsky Prospect, 27/10, Moscow, 119192, Russian Federation

Phone: +7-985-100-07-94

axtroz4894@gmail.comФГАОУ ВО “Первый Московский государственный медицинский университет им. И.М. Сеченова” Министерства здравоохранения Российской Федерации (Сеченовский Университет)РоссияSechenov First Moscow State Medical University (Sechenov University)Russian FederationМосковский государственный университет им. М.В. Ломоносова, факультет фундаментальной медициныРоссияLomonosov Moscow State UniversityRussian FederationФГБОУ ВО “Московский государственный медико-стоматологический университет им. А.И. Евдокимова” Министерства здравоохранения Российской ФедерацииРоссияYevdokimov Moscow State University of Medicine and DentistryRussian Federation2020170320202516978Copyright © Галлямов Э.А., Агапов М.А., Луцевич О.Э., Какоткин В.В., 20202020Галлямов Э.А., Агапов М.А., Луцевич О.Э., Какоткин В.В.Gallyamov E.A., Agapov M.A., Lutsevich O.E., Kakotkin V.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://hepato.elpub.ru/jour/article/view/604

Работа основана на анализе данных литературы, посвященной проблеме выбора оперативного пособия при остром панкреатите, за последние 30 лет. Главная цель обзора – выявить ключевые этапы эволюции хирургического подхода к лечению больных инфицированным панкреонекрозом, а также определить наиболее перспективные хирургические методы лечения среди существующих. Проведен анализ наиболее современных клинических рекомендаций, принятых в разных странах мира, а также поиск таких проблем, решение которых будет являться главной задачей мировой медицинской науки в ближайшее время. Установлено, что медицинскими сообществами разных стран отдается предпочтение минимально инвазивным методам санации: чрескожному и транслюминальному эндоскопическому дренированию. Согласно наиболее продвинутым рекомендациям, метод выбора при хирургическом лечении инфицированного панкреонекроза – транслюминальное эндоскопическое дренирование, при неэффективности – чрескожное пункционное дренирование. Главная идея, определяющая вектор поиска методов лечения заболевания, – признание того факта, что все хирургические доступы направлены на достижение одной цели – удаление максимально возможного объема некротических масс с минимальным повреждением окружающих тканей. Только тот метод, который удовлетворяет обоим требованиям, может быть признан ведущим.

This work is based on analysis of publications devoted to the problem of surgical approach to treatment of acute pancreatitis over the last 30 years. The main aim of this review is to identify the key steps of evolution of surgical approach to treatment of infected pancreatic necrosis and also to determine the most promising approach among existing methods. The analysis of the most modern clinical recommendations adopted in different countries of the world, as well as the search for such problems, the solution of which will be the main task of world medical science in the near future, is carried out. It has been established that medical communities of different countries give preference to minimally invasive methods of debridement: percutaneous and transluminal endoscopic drainage. According to the most advanced recommendations, the method of choice for surgical treatment of infected pancreatic necrosis is transluminal endoscopic drainage, with inefficiency – percutaneous puncture drainage. The main idea that defines the search vector for treatment methods for the disease is the recognition of the fact that all surgical approaches are aimed at achieving one goal – removing the maximum possible volume of necrotic masses with minimal damage to surrounding tissues. Only a method that satisfies both requirements can be recognized as leading.

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