IMPROVEMENT OF SURGICAL TREATMENT OF ACUTE BILIARY PANCREATITIS.

Thus, complications after surgical treatment of biliary pancreatitis occurred in 17.9% (n=7) of patients, including bile leakage at the site of the drainage tube placement 2.6% (n=1), biliodigestive anastomosis failure 2.6% (n=1), scar stenosis of the terminal part of the common bile duct after drainage 5.1% (n=2), increased severity of acute pancreatitis 5.1% (n=2) after endoscopic lithotripsy, fluid accumulation in the subcutaneous tissue (seroma) 5.1% (n=2). There were 5.1% (n=2) deaths. The causes of death were recurrent erosive bleeding with total pancreatic necrosis and septic shock with the development of multi-organ dysfunction. In complicated cases of acute biliary pancreatitis, when there was a need for simultaneous surgical intervention on the gallbladder, bile ducts, pancreas, and retroperitoneal space, we used our developed universal wound expander (EAPO No. 038346 dated 12.08.2021). The wound expander allows for better visibility of the surgical field and significantly facilitates the surgeon's work during the surgical procedure. The double-lumen spiral drain (No. 7691 dated 13.10.2023) provides adequate drainage and continuous flushing, as well as irrigation with medications to prevent further destruction of the pancreatic parenchyma and the development of purulent-septic complications. To monitor the dynamics of treatment for pancreatic necrosis during subsequent sanations, we also used the method of omentobursoscopy (No. 36736 dated 02.08.2024) in the postoperative period, which allowed for controlled manipulations in the omental bursa and retroperitoneal space, creating conditions for higher quality and safer work for the surgeon in the treatment of acute purulent pancreatitis.