Year 2013 Vol. 21 No 2




ME Mozyr City Hospital
The Republic of Belarus

Accepted in 1992 at Atlanta Symposium of pancreatologists such terms as acute fluid collection, pancreatic necrosis, pseudocyst and pancreatic abscess are used inconsistently, without proper compliance with the classification.
Better understanding of the pathophysiology of necrotizing pancreatitis, advanced imaging techniques, accumulation of the research results made possible for the Acute Pancreatitis Working Group in 2012 to develop a new classification, dividing collections into 4 types: acute peripancreatic fluid collection, pseudocyst, acute necrotic collection and walled-off pancreatic necrosis. In contrast to the statements of Atlanta Symposium this new classification subdivides acute necrotic collection and walled-off necrosis, emphasizing that acute necrotic collection develops within the first 4 weeks of acute pancreatitis and pancreatic walled-off necrosis develops later. Each type of collections can be sterile or infected. Acute peripancreatic fluid collections develop at the early stage of the disease and most of them can resolve spontaneously. If acute peripancreatic fluid collection exists longer than 4 weeks, it should be called a pseudocyst. Interventions required only in the case of infected collection, otherwise conservative treatment is indicated. Disturbance of the duct integrity supports the existence of all types of collections and affects on the outcome of drainage procedures. Optimal time to perform a surgical intervention is considered within 3-4 weeks after completion of necrosis demarcation. Minimally invasive interventions such as laparoscopic, percutaneous and endoscopic retroperitoneal are considered as an equivalent to open necrosectomy.

Keywords: acute peripancreatic fluid collection, acute necrotic collection, pseudocyst, walled-off necrosiss
p. 111 118 of the original issue
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Address for correspondence:
247760, Respublika Belarus', g. Mozyr', ul. Kotlovtsa, d. 14 a, UZ Mozyrskaia gorodskaia bol'nitsa,
Khokha Vladimir Mikhailovich
Information about the authors:
Khokha V.M. Deputy of chief physician on surgery of ME Mozyr city hospital.
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