[Changes in the pancreatic ducts and the tactics in the treatment of acute pancreatitis].

On the basis of multiple-factor analysis of changes of the pancreatic duct system in acute pancreatitis and comparison with the criteria of its clinico-laboratory characteristics, the authors determined the contribution of the system to the pathogenesis of the disease and the formation of the nature of the affection of the organ (edematous or destructive pancreatitis). A mathematical model of the pancreatic system in acute pancreatitis was developed, which allowed the form of the disease to be recognized from 3 dominating factors. Improved complex diagnosis of acute pancreatitis with appraisal of the condition of the pancreatic duct system, and a differentiated approach to the choice of the operation and the optimal time of its performance made it possible to improve the general results of the treatment of patients with acute pancreatitis, evidence of which is presented in comparison of the indices of 1981-1983 with those of 1984-1986. Thus, despite the growth of surgical activity in 1984-1986 (from 19.6% to 32.2%), postoperative mortality was 14.7%, whereas in 1981-1983 it was 29.2% in a practically stable value of total mortality in the recent 6 years (8.1-7.7%).