ПОСТМАНИПУЛЯЦИОННЫЙ ПАНКРЕАТИТ: АКТУАЛЬНОСТЬ ПРОБЛЕМЫ, СЛОЖНОСТИ ДИАГНОСТИКИ И НЕРЕШЕННЫЕ ПРОБЛЕМЫ

Acute postmanipulation pancreatitis (APMP) is a widespread complication of interventions on the duodenal papilla. Despite the use of known methods of prevention, the frequency of its occurrence reaches 40 % of cases. Severe pancreatitis often leads to pancreatonecrosis and sometimes to fatal outcome. Objective – to investigate the problem of pharmacological prevention of APMP. Materials and methods. The analysis included the data on pharmacological prevention of postmanipulation pancreatitis in domestic and foreign literature in PubMed and Elibrary databases for the last 10 years. Results. The analysis of the data indicates that the APMP develops in 1-40 % of patients after the intervention on the duodenal papilla area. In patients in high risk group (in the presence of three or more risk factors: female gender, sphincter of Oddi dysfunction, young age, history of pancreatitis, difficult cannulation, preliminary papillotomy, chemical or hydrostatic pancreatic duct damage and others), APMP develops in 4.7 %. Pancreatonecrosis develops in 15 % of cases, with mortality reaching 85 %. According to the researches, APMP develops in 4 % despite administration of pharmacological prevention. Conclusions. For prevention, it is necessary to identify and take into account all potential risk factors relating to the patient and a procedure before the intervention. The problem of prevention of postmanipulation pancreatitis remains complicated and requires further researching. It is necessary to search new methods of prevention and investigate various ways pharmacotherapy of patients. It is necessary to develop the national guidelines for prevention and management of patients with APMP.