clinmedКлиническая медицинаClinical Medicine (Russian Journal)0023-21492412-1339ООО «Медицинское информационное агентство»10.30629/0023-2149-2023-101-9-10-496-501clinmed-637Research ArticleОРИГИНАЛЬНЫЕ ИССЛЕДОВАНИЯORIGINAL INVESTIGATIONSВыбор диаметра дренажа при первичном дренировании у пациентов с острым гнойно-некротическим парапанкреатитомSelection of drain diameter in initial drainage of patients with acute necrotizing pancreatitishttps://orcid.org/0000-0001-9410-9493РемизовС. И.RemizovS. I.

Ремизов Станислав Игоревич — канд. мед. наук, врач-хирург отделения рентгенохирургических и ультразвуковых методов диагностики и лечения

350012, Краснодар

350063, Краснодар

Remizov Stanislav I.

350012, Krasnodar

4350063, Krasnodar

masterr58@myrambler.ruhttps://orcid.org/0000-0003-0945-9400АндреевА. В.AndreevA. V.

Андреев Андрей Викторович — д-р мед. наук,заведующий отделением рентгенохирургических и ультразвуковых методов диагностики и лечения №1; профессор кафедры хирургии № 2 факультета повышения квалификации и профессиональной переподготовки специалистов

350012, Краснодар

350063, Краснодар

Andreev Andrey V.

350012, Krasnodar

4350063, Krasnodar

https://orcid.org/0000-0002-7420-0553ДурлештерВ. М.DurleshterV. M.

Дурлештер Владимир Моисеевич — заместитель главного врача по хирургии; д-р мед. наук, профессор, заведующий кафедрой хирургии № 3

350012, Краснодар

350063, Краснодар

Durleshter Vladimir M.

350012, Krasnodar

4350063, Krasnodar

https://orcid.org/0000-0002-0755-903XГабриэльС. А.GabrielS. A.

Габриэль Сергей Александрович — д-р мед. наук, главный врач ГБУЗ ККБ № 2; профессор кафедры хирургии № 3

350012, Краснодар

350063, Краснодар

Gabriel Sergey A.

350012, Krasnodar

4350063, Krasnodar

https://orcid.org/0000-0003-0625-0791ЗасядькоО. В.ZasyadkoO. V.

Засядько Ольга Вячеславовна — интерн, кафедра хирургии № 3

350063, Краснодар

Zasyadko Olga V.

4350063, Krasnodar

ГБУЗ «Краевая клиническая больница № 2» Минздрава Краснодарского края; ФГБОУ ВО «Кубанский государственный медицинский университет» Минздрава РоссииРоссияRegional Clinical Hospital №2 of the Ministry of Health of the Krasnodar Region; Kuban State Medical University of the Ministry of Health of RussiaRussian FederationФГБОУ ВО «Кубанский государственный медицинский университет» Минздрава РоссииРоссияKuban State Medical University of the Ministry of Health of RussiaRussian Federation2023141120231019-10496501Copyright © Ремизов С.И., Андреев А.В., Дурлештер В.М., Габриэль С.А., Засядько О.В., 20232023Ремизов С.И., Андреев А.В., Дурлештер В.М., Габриэль С.А., Засядько О.В.Remizov S.I., Andreev A.V., Durleshter V.M., Gabriel S.A., Zasyadko O.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.clinmedjournal.com/jour/article/view/637

Цель исследования. Оценить результаты лечения гнойно-некротического парапанкреатита с использованием дренажей различного диаметра у пациентов с острыми некротическими скоплениями. Материал и методы. В период с 2013 по 2018 г. было пролечено с использованием минимально инвазивных хирургических технологий 124 человека с гнойно-некротическим парапанкреатитом. 1-ю группу составили 56 пациентов, которым на первоначальном этапе вводились дренажи диаметром 8–16 Fr, во 2-ю вошли 68 человек, у которых использовались дренажи 28–32 Fr. Груп- пы пациентов были сопоставимы по основным показателям (p > 0,05). Результаты. В 1-й группе замена на дренажи более крупного диаметра понадобилась в 100% случаев, во 2-й — у 18,7% пациентов (p < 0,05). В качестве окончательного метода лечения пункционно-дренирующая технология была использована в 1-й группе у 31 (55,4%) больного, во 2-й — у 57 (83,8%) (p < 0,05). Количество периоперационных осложнений составило 51,7% в 1-й и 16,1% во 2-й группе (p < 0,05). Длительность госпитализации в первой группе была больше в среднем на 16 ± 7,3 дня. Летальность в 1-й группе составила 30,4%, во 2-й — 11,8% (p < 0,05). Заключение. Использование широкопросветных дренажей на первоначальном этапе повышает эффективность пункционно-дренирующего лечения гнойно-некротического пара- панкреатита и позволяет добиться снижении летальности.

Objective. To evaluate the treatment outcomes of acute necrotizing pancreatitis using drains of different diameters in patients with acute necrotic accumulations. Materials and methods. From 2013 to 2018, 124 patients with acute necrotizing pancreatitis were treated using minimally invasive surgical techniques. Group 1 consisted of 56 patients who were initially given drains with a diameter of 8–16 Fr, while Group 2 consisted of 68 patients who were given drains with a diameter of 28–32 Fr. The patient groups were comparable in terms of main indicators (p > 0.05). Results. In Group 1, replacement with larger diameter drains was needed in 100% of cases, while in Group 2 it was needed in 18.7% of patients (p < 0.05). As a final treatment method, puncture-drainage technology was used in Group 1 for 31 (55.4%) patients, and in Group 2 for 57 (83.8%) (p < 0.05). The incidence of perioperative complications was 51.7% in Group 1 and 16.1% in Group 2 (p < 0.05). The duration of hospitalization in Group 1 was on average 16 ± 7.3 days longer. Mortality rate was 30.4% in Group 1 and 11.8% in Group 2 (p < 0.05). Conclusion. The use of wide-bore drains at the initial stage increases the effectiveness of puncture-drainage treatment of acute necrotizing pancreatitis and allows for a reduction in mortality rate.

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