Affiliation:
1. Volgograd State Medical University
Abstract
Background. Acute pancreatitis retains its leading position in the structure of urgent abdominal pathology, maintaining a high postoperative mortality, despite the emergence of new methods of surgical treatment.The aim of the study: to evaluate pathomorphological changes in the pancreas, surrounding organs and tissues, clinical manifestations in dynamics after local cryotherapy on the pancreas in animals with experimental pancreatic necrosis for subsequent use of the method in clinical practice.Material and methods. An experimental study was performed on Wistar rats, in the main group, pancreatic necrosis was simulated with subsequent cryotherapy, in the control group, pancreatic necrosis was simulated and simple pancreatic mobilization was performed, in the third group, cryotherapy was performed on an unchanged gland. With the help of modern statistical methods, the effectiveness and safety of cryotherapy techniques were evaluated.Results. The optimal duration of cryoapplication is an interval of 3–4 seconds at a temperature of –195.75 °C, it is not accompanied by the formation of a cryonecrosis zone, promotes the regeneration of acinuses, does not damage the accumulation of endocrine cells, interrupting the course of pancreonecrosis, does not lead to a fatal outcome, a pronounced adhesive process, other serious intraabdominal complications.Conclusion. Cryotherapy on the pancreas in experimental pancreatic necrosis in the optimal temperature-time regime is accompanied by significantly lower mortality, is a safe technique and can be tested in clinical practice for the treatment of patients with this pathology.
Subject
General Immunology and Microbiology,General Biochemistry, Genetics and Molecular Biology
Reference30 articles.
1. Dibirov MD, Domarev LV, Shitikov EA, Isaev AI, Karsotyan GS. Principles of “cliff” pancreatic necrosis in a first-aid hospital. Pirogov Russian Journal of Surgery. 2017; (1): 73-77. (In Russ.) doi: 10.17116/hirurgia2017173-77
2. Rodoman GV, Shalaeva TI. The risk of minimally invasive interventions in severe acute pancreatitis. Khirurg. 2018; 3-4(161): 33-42. (In Russ.).
3. Hines OJ, Pandol SJ. Management of severe acute pancreatitis. BMJ. 2019; 367: l6227. doi: 10.1136/bmj.l6227
4. Leppäniemi A, Tolonen M, Tarasconi A, Segovia-Lohse H, Gamberini E, Kirkpatrick AW, et al. 2019 WSES guidelines for the management of severe acute pancreatitis. World J Emerg Surg. 2019; 14: 27. doi: 10.1186/s13017-019-0247-0
5. Avakimyan S, Popandopulo K, Avakimyan V, Didigov M, Marinochkin A. Options for drainage of the purulentnecrotic process in destructive pancreatitis. Danish Scientific Journal. 2020; 33(1): 18-23.