Introducere: În pancreatita acutã de origine biliarã momentul principal etiopatoginetic este hipertensiunea ductalã a cãrei suprimare
are importanåã vitalã în evoluåia bolii.
Scopul lucrãrii: Aprecierea eficacitãåii metodelor decompresive laparo-endoscopice aplicate în faza precoce a bolii ca prima etapã a
tratamentului chirurgical.
Material æi metode: Au fost analizate rezultatele tratamentului laparo-endoscopic la un lot de 256 pacienåi cu PA severã de etiologie
biliarã (edimatoasã – 70, distructivã – 186). În dependenåã de tabloul clinic bolnavii devizaåi în 2 subloturi. Bolnavilor din primul
sublot cu prevalenåa simptoamelor de colecisto-pancreatitã æi semne peritoneale le-au fost aplicate intervenåii laparoscopice decompresive:
colecistostomia transhepaticã laparoscopicã – 50, colecistolitostomia cu asistenåã laparoscopicã – 126, colecistectomia
laparoscopicã cu drenarea CBP tip Holsted – 20. În afarã de intervenåiile decompresive bolnavilor cu peritonitã fermentativã æi
omentobursitã le-au fost efectuate lavajul peritoneal laparoscopic, sanarea æi drenarea bursei omentale. Pacienåilor din sublotul doi
– 60, la care predomina colangita æi icterul mecanic pentru deblocarea arborelui biliopancreatic efectuatã PSTE cu litextracåia.
Rezultate: În urma complicaåiilor din grupul bolnavilor cu pancreatitã distructivã au decedat 11(5,9%) pacienåi, letalitatea medie fiind
de 4,3%, indice spectaculos pentru acest contingent grav de bolnavi.

Introduction: The major etiopathogenetic factor in acute biliary pancreatitis is ductal hypertension by suppression and has a vital
importance in the evolution of the disease.The goal. Assessing the efficacy of laparo-endoscopic decompressive methods applied
at the early stage of the disease as the first step of surgical treatment.
Material and methods: The results of the laparo-endoscopic treatment were analyzed in a group of 256 patients with severe biliary
pancreatitis (edematous - 70, destructive - 186). The patients are divided into 2 lots depending on the clinical manifestations.The
patients in the first lot with the prevalence of cholecysto-pancreatitis symptoms and peritoneal signs were subjected to decompressive
laparoscopic interventions: laparoscopic transhepatic cholecystectomy - 50, laparoscopic cholecystolithostomy - 126,
laparoscopic cholecystectomy with drainage of main bile ducts type Holsted-20. Besides the decompressive interventions in the
patients with fermentative peritonitis and omentitis, the laparoscopic peritoneal lavage and the drainage of the omental bursa were
performed. Patients in the second lot - 60, with colangitis and mechanical jaundice underwent EPST with litextraction for decompression
of main biliary ducts.
Results: The 11 (5.9%) patients diedin the group with destructive pancreatitis, with an average lethality of 4.3%, a spectacular index
for this grave contingent of the patients.