METHOD FOR INCREASING EFFECTIVENESS OF ENDOSURGICAL MANAGEMENT OF PATIENTS SUFFERING ACUTE BILIARY PANCREATITIS

摘要

FIELD: medicine.;SUBSTANCE: thoracic epidural analgesia is conducted by puncturing and catheterisation of an epidural space at ThVIII - ThIX before the expiry of 24 hours from the onset of a disease after a moderate intravenous infusion therapy in the amount of 15-20 mg/kg of crystalloid solutions. 20 minutes before an expected endoscopic papillosphincterotomy, a catheter is moved 4-5 cm in a cranial direction. At ThV-ThX, 0.4% naropin 10-12 ml or 0.2% Marcaine 10-12 ml and clonidine 100 mcg are administered through a catheter. That is followed by a pre-medication by administering 0.1% atropine 0.5-1 ml and 0.5% relanium 1-2 ml. Thereafter, the patient is taken to an X-ray operation room to conduct the endoscopic papillosphincterotomy without an endoscopic retrograde cholangiopancreatography with general pancreatic duct stenting. After the operation has been completed, the patient is taken to an intensive care unit wherein an extended epidural analgesia is conducted by administering 0.2% naropin 10-12 ml or 0.15% marcaine 10-12 ml into the epidural space every 4 hours until the patient is taken to a department of surgery.;EFFECT: early intestinal motility recovery, increased pancreatic secretion, prevented spasm of the gastrointestinal sphincter ensured by a pathological complete blockade of sympathetic impulsing.;1 ex