Biliary acute cholecystopancreatitis

In recent years, in domestic and foreign literature, a large number of works devoted to acute cholecystopancreatitis. This is explained, first, by a growing number of patients with this pathology. In hospitals emergency abdominal surgery specific weight of such patients is 30 %. Second, it is connected with the severity of the disease mortality, despite the success of modern anesthesiology and resuscitation, is 10 % or more.
Currently, medical practice has a sufficient Arsenal of special methods of research to detect the pathology of a biliary ducts, which causes pancreatitis. It is known that cholecystopancreatitis as pancreatitismay develop when duodenostasis, vascular, hypersecretory, allergic, neuro-trophic disorders and other So one of the forms of biliary acute pancreatitis, the main causes of its development are pathological conditions of the biliary tract, accompanied by their injury and causing the simultaneous occurrence of acute cholecystitis, ductal hypertension and biliopancreatic of reflux, we called biliary acute cholecystopancreatitis. This term reflects the etiology and pathogenesis of pathological processes in the pancreas.
I. Polivanov (1965), Kessler, Mieny (1975), Niderle (1976), Ribolic and co-authors (1977), Stulhofer and co-authors (1977) the main cause of acute cholecystopancreatitis believe calculous and the so-called acalculous cholecystitis. However, concrete evidence, they do not lead.
The widespread idea that the sharp cholecystopancreatitis occurs due to reflux of bile in the pancreatic ducts (Opie, 1903)should be clarified, as Lagerfol (1947), Beck and co-authors (1961) proved the innocence of bile in the absence of damage acinar cells. When receiving a larger amount of bile, it takes action inhibitor of pancreatic enzymes (Zollinger and co-authors, 1954, and others).
Therefore, in the development of biliary acute cholecystopancreatitis play the role of other reasons. One of these reasons we consider an acute injury of the mucous membrane of the major duodenal papilla, accompanied by the release of cellular tsitokinazy, activating enzymes gland in the injured area. In further developing ductal hyperfermentemia and hypertension, bile reflux and enzymes, is the penetration of the infection in the ducts of the pancreas. Arising in pancreatic ducts hypertension, joining the vascular, nervous-trophic, allergic, and possibly hypoxic, and other components contributes to the progression of the disease.
Great difficulties arise diagnosis of biliary acute cholecystopancreatitis, as the literature data about the changes of laboratory parameters in this disease ambiguous (Amman, 1976; Sery, Krai, 1977, and others).
High mortality in biliary acute cholecystopancreatitis explained by severity of its course and no single treatment and tactical principles, although the range of the applied methods of treatment, including surgical, very wide. However, indications for one or another type of surgical intervention, particularly when complications occur, yet to be finalized.