The article provides a literary review of the fundamentals, role in clinical practice, and possibilities of selective perioperative intestinal decontamination. Aspects of prevention of postoperative wound complications and anastomosis insufficiency in colorectal surgery are analyzed. The key point is to reduce the number of certain bacterial strains that contribute to the development of exponential inflammation in the anastomosis zone. Modern schemes for the use of oral decontamination and their combination with intravenous antibiotic prophylaxis for the failure of anastomoses of the left half of the colon and rectum are considered.
The paper presents a description of long-term minimally invasive treatment of a patient with chronic biliary pancreatitis. The treatment consisted in stenting the pancreatic duct with plastic stents, their replacement, bougienage of strictures, drainage of a festering pancreatic pseudocyst, and lithoextraction from the common bile duct. A multidisciplinary assessment of gradually developing complications was not performed. No discussions with pancreatic surgeons on indications for radical resection intervention were held. This treatment strategy led to the syndrome of chronic abdominal pain, recurrent complications after endoscopic minimally invasive treatment, as well as to a significant deterioration in the quality of life. The patient developed depression. Clinical observation clearly demonstrates that it is only possible to determine the optimal timing and indications for resection intervention on the pancreas in complicated chronic pancreatitis within the framework of an interdisciplinary approach.
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