The article presents the opportunities and experience of using laparoscopic techniques for the diagnosis and treatment of patients with generalized peritonitis. Primarily, laparoscopy was used only as a diagnostic method to visually assess the abdominal cavity state with minimum damage to tissues. The laparoscopy rapid development is associated with new videoendoscopy equipment emergence. Laparoscopy in abdominal cavity acute surgical diseases can reduce the unnecessary number of laparotomy. Currently, many authors consider laparoscopic sanitation as an alternative method to abdominal cavity programmed revisions and sanitations. Materials and Methods. The use of minimally invasive methods for treatment of purulent-septic complications of pancreatonecrosis in 159 patients reduced the number of laparotomies and decreased mortality in this group of patients. Results and Discussion. Based on the conducted analysis of treatment of 174 patients with destructive pancreatitis with using minimally invasive surgical interventions (laparoscopic and puncture-draining operations) it was revealed that the effectiveness of minimally invasive surgery in pancreatic necrosis directly depends on the prevalence of the pathological process. Implementation of stepwise approach with few invasive technologies, as a starting method, significantly improves the results of treatment of patients with destructive pancreatitis. For limited forms of pancreatic necrosis, minimally invasive surgery is the method of choice, and this surgical direction has one of the leading roles in improving treatment outcomes in the general number of patients with destructive pancreatitis. In recent years, the methods of laparoscopic pancreateo-bulboscopy and sanitation of the gland bag have been actively used. With the help of endoscopic technique, laparoscopy, pancreatic decompression (pancreas), sanation and drainage of the abdominal cavity and then using specially developed instruments from minilaparotomy access are performed to examine the pancreas, its abdominization, necro- and sequestrectomy and form pancreatoautoburson and / or lumbar. In the subsequent, stage reorganization is carried out, and between the operations through the drainage flow or fractional lavage of the cavity of the stuffing bag is carried out. Adequate sanation, drainage of pathological foci in combination with low surgical access aggression in these interventions provide advantages over traditional treatments. Another factor determining the more favorable course of the postoperative period was the minimal destruction of the anatomical and physiological barriers around pathological foci, which results in a smaller increase in endogenous intoxication than in open operations. Conclusions. Gathered experience demonstrated broad possibilities of laparoscopy in the peritonitis treatment. The result of the operative laparoscopy using has been a significant reduction of patients stay in hospital. Different authors note wound complications reduction, patients rehabilitation period reduction, rapid pain relief and a good cosmetic effect, associating it with the minimally invasive nature of the surgery.
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