Algorithm of a new approach to the treatment of patients in the early phase of acute pancreatitis and evaluation of the results of its application

Objective. To improve immediate treatment outcomes for patients with acute pancreatitis (AP) by personalizing the treatment and diagnostic approach and introducing new methods of providing medical care at the early stage of the disease.

Materials and methods. A personalized treatment and diagnostic approach has been developed for the early phase of acute pancreatitis, the essence of which lies in the consistent identification of indications for early minimally invasive puncture-drainage interventions. The experience of medical care provided to 1,364 patients with acute pancreatitis, who were treated in the 10th City Clinical Hospital of Minsk from 2018 to 2025, was studied in a comparative way. Such indicators as operational activity, the proportion of minimally invasive interventions, their effectiveness, the percentage of open operations, and mortality were evaluated.

Results. The clinical application of a new personalized approach to surgical treatment in ANP and developed new methods has reduced operative activity from 14.6 to 9.4 %, increased the proportion of minor invasive puncture-drainage interventions with 89,3 to 97.3 %, increase their effectiveness (the share of such interventions as the final treatment method increased from 72 to 81.9 %), reduce the rate of laparotomy operations from 10.7 to 2.7 %, which combined led to a reduction in overall mortality for acute pancreatitis from 5.8 to 4.4 % and its severe form with 19,2 to 12.9 %.

Conclusion. The results of the study made it possible to propose early diagnostic criteria for practical use, show the way to obtain them and evaluate them clinically, and justify recommendations in which specific cases it is advisable to make tactical decisions in favor of early minimally invasive drainage of fluid collection in ANP.

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