This article presents the experience of complex treatment of 104 patients with destructive pancreatitis. All patients were divided into groups depending on the Quetelet index, respectively, patients with normal and overweight, including obesity from I to III degree. Comparative characteristics of the results of treatment of all groups showed that pancreatic necrosis, in patients with a high index of Quetelet, is severer than in patients with a lower index, the duration of inpatient treatment is longer, the severity of the general condition is worse, the need for application and the volume of invasive methods of treatment is higher. The urgency of the problem of acute pancreatitis and destructive pancreatitis is due to the fact that this problem is one of the most difficult in emergency surgery of the abdominal cavity organs. The number of patients with acute pancreatitis and destructive pancreatitis continues to grow steadily every year. On the frequency of hospitalization in urgent surgery, this disease has come to be one of the first places. Despite the successes achieved in the improvement of diagnostics, intensive care, antibacterial prophylaxis, surgical methods of treatment with the use of the possibilities of minimally invasive surgery, the overall mortality in destructive pancreatitis has remained at a high level (10-30%) for the last decades and reaches 85% for infected pancreatonecrosis. Obesity affects from 24.8 to 32.8% of the population in different countries, which represents a significant proportion of the total population. In turn, these individuals have characteristic constitutional features, in particular, the volume of retroperitoneal tissue is much larger, and therefore one can assume a difference in the course of pancreatic necrosis. All patients underwent a generally accepted approach of diagnosing and treating destructive pancreatitis. Comorbid diseases were also excluded, which could affect the course of destructive pancreatitis. The data obtained during the study show that the course of PN in a patient with obesity is significantly severer than in patients with normal and overweight degree. The severity of the course of the disease and mortality significantly increases with the growth of the body mass index. This can be associated with a large volume of retroperitoneal tissue and, as a consequence, with a large volume of "substrate" that undergoes destruction and infection. For clarification, it is necessary to further study this issue. The results obtained will help improve the ability to predict and treat patients with destructive pancreatitis.
Keywords: acute pancreatitis, pancreonecrosis, Quetelet index
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