Miniinvasive surgical treatment of acute biliary pancreatitis
Clinical examination and treatment of 126 patients with acute biliary pancreatitis was performed. There were 32 men (25,4 %) and 94 women (74,6 %). Most of the patients were within the age of 41 to 60 (59,5 %). To select the method of surgical treatment and surgical intervention in acute biliary pancreatitis, we divided the patients into three groups. First group of 65 patients who experienced with isolated cholecystolithiasis. Second group of 35 patients who were verified the presence of small concrements in different parts of the biliary tract not causing obturation of common bile duct. Third group of 26 patients who had confirmed obturated concrements of common bile duct with impaction in duodenal ampulla. It was determined that in patients with acute biliary pancreatitis and isolated cholecystolithiasis use of endoscopic retrograde cholangiopancreatography and endoscopic papillotomy is unsubstantiated and it should be avoided, while operation of choice shall be a laparoscopic cholecystectomy. In the second group of patients (acute biliary pancreatitis with cholelithiasis) endoscopic papillotomy intervention was reasonable and should be done for decompression of common bile duct and determination of further treatment strategy. The next step is performance of laparoscopic cholecystectomy. In patients with acute biliary pancreatitis and calculus impaction into duodenal ampulla (third group) endoscopic retrograde cholangiopancreatography and papillotomy is a pathogenetically substantiated diagnostic and therapeutic measure, which should be performed in the shortest possible time, allowing the elimination of clinical manifestations of obturative jaundice and acute biliary pancreatitis.