THE PROBLEM OF CHRONIC PANCREATITIS FROM POINTS OF VIEW THERAPEUTIST AND SURGEON

There were analysed results of diagnosis and treatment of 415 chronic pancreatitis (CP) patients. Indications for surgical treatment were set for 298 (71,8%) patients, non-surgical treatment - for 117 (28,2%), the patients were subdivided in accordance with the international Marseilles-Rome classification of CP (1988) into three forms: calcifying, obstructive, inflammatory. The use of modern methods in the diagnosis and treatment of CP patients allowed to modify the classification and distinguish subgroups for each form of the disease. It is established that the use of modern minimally invasive technologies in the diagnosis and treatment of CP patients expands opportunities of the delivery of medical care at high level, with the minimum of complications, with high quality of life. In the non-surgical treatment along with the use of traditional approaches it is reasonable obligatorily to take into account metabolic alterations with the purpose of their correction, first of all through restoration of adequate functioning of intestinal microbial-tissue complex. The patients with CP complications should be under surgical treatment with the use of the whole range of operational resources, with a complete substantiation of intervention type when the non-surgical therapy resources are exhausted or the ineffectiveness of non-surgical therapy because of complications development is evident. There is shown the necessity of recognition of wider clinical view of CP problem for substantiation of adequate individualized treatment policy.