actabiomedicaActa Biomedica ScientificaActa Biomedica Scientifica2541-94202587-9596Scientific Centre for Family Health and Human Reproduction Problems10.29413/ABS.2025-10.4.20actabiomedica-5567Research ArticleХИРУРГИЯSURGERYЛучевая диагностика панкреонекроза: современный взгляд (обзор литературы)Imaging modalities for necrotizing pancreatitis: what’s new (literature review)https://orcid.org/0000-0002-4743-4565ЧерданцевД. В.CherdantsevD. V.

Черданцев Дмитрий Владимирович – доктор медицинских наук; профессор; заведующий кафедрой госпитальной хирургии им. проф. А.М. Дыхно с курсом ПО 

660022; Красноярский край; г. Красноярск; ул. Партизана Железняка; зд. 1

Dmitrij V. Cherdancev – Dr. Sci. (Med.); Professor; Head of the Department of Hospital Surgery named after Professor A.M. Dykhno

Partizana Zheleznyaka st.; 1; Krasnoyarsk region; Krasnoyarsk 660022

gs7@mail.ruhttps://orcid.org/0000-0002-1221-030XНосковИ. Г.NoskovI. G.

Носков Игорь Геннадьевич – кандидат медицинских наук; доцент кафедры госпитальной хирургии им. проф. А.М. Дыхно с курсом ПО 

660022; Красноярский край; г. Красноярск; ул. Партизана Железняка; зд. 1

Igor` G. Noskov – Cand. Sci. (Med.); Associate Professor of the Department of Hospital Surgery named after Professor A.M. Dykhno

Partizana Zheleznyaka st.; 1; Krasnoyarsk region; Krasnoyarsk 660022

igornoskov@mail.ruhttps://orcid.org/0009-0006-4507-1525ТахтобинЕ. Г.TakhtobinE. G.

Тахтобин Евгений Геннадьевич – соискатель кафедры госпитальной хирургии им. проф. А.М. Дыхно с курсом ПО 

660022; Красноярский край; г. Красноярск; ул. Партизана Железняка; зд. 1

Evgenij G. Taxtobin – applicant of the Department of Hospital Surgery named after Professor A.M. Dykhno

Partizana Zheleznyaka st.; 1; Krasnoyarsk region; Krasnoyarsk 660022

teg294@mail.ruФедеральное государственное бюджетное образовательное учреждение высшего образования «Красноярский государственный медицинский университет имени профессора В.Ф. Войно-Ясенецкого» Министерства здравоохранения Российской ФедерацииProf. V.F. Voino-Yasenetsky Krasnoyarsk State Medical University of the Ministry of Healthcare of the Russian Federation202523092025104201213Copyright © Черданцев Д.В., Носков И.Г., Тахтобин Е.Г., 20252025Черданцев Д.В., Носков И.Г., Тахтобин Е.Г.Cherdantsev D.V., Noskov I.G., Takhtobin E.G.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.actabiomedica.ru/jour/article/view/5567

Панкреонекроз — диффузные или очаговые зоны нежизнеспособной паренхимы поджелудочной железы; которые; как правило; сочетаются с некрозом забрюшинной жировой клетчатки и сопровождаются высоким риском развития грозных осложнений; таких как сепсис; синдром системного воспалительного ответа; полиорганная недостаточность и другие. Частота летальности при инфицированном панкреонекрозе достигает 60-80 %; представляя огромную проблему неотложной абдоминальной хирургии. Панкреонекроз чаще развивается у людей молодого и среднего возраста; что делает его и важной социальной проблемой. Несмотря на последние достижения в области панкреатологии; совершенствования методов диагностики и появления новых методов лечения; сохраняются трудности в выборе оптимальной лечебно-диагностической тактики при панкреонекрозе.

В обзорной статье мы проанализировали последние исследования; представленные в открытых источниках; посвященные диагностике и лечению острого панкреатита. Поиск научных публикаций был произведен в электронной базе данных Научной библиотеки России (eLibrary.ru) и Национальной медицинской библиотеки США (PubMed.org) на русском и английском языках. В качестве поисковых запросов использовались следующие ключевые слова: острый панкреатит (acute pancreatitis); панкреонекроз (necrotizing pancreatitis); УЗИ (ultrasound); КТ (CT); МРТ (MRI); ЭУС (EUS); а также их сочетания с целью сужения поиска проблематики. В работе подробно рассмотрены методы лучевой диагностики панкреонекроза (УЗИ; КТ; МРТ; ЭУС); которые позволяют выявить некроз паренхимы поджелудочной железы; наличие местных осложнений острого панкреатита и оценить степень тяжести. Авторы анализируют преимущества и ограничения каждого метода; а также обсуждают особенности интерпретации результатов. В частности; исследована роль лучевых методов исследования для оценки степени тяжести острого панкреатита в сравнении с общепризнанными шкалами – MCTSI; BISAP; APACHE-II; SOFA; Ranson и показателем С-реактивного белка. Также систематизированы данные по диагностическим критериям синдрома разобщения панкреатического протока.

Статья будет полезна для специалистов в области лучевой диагностики; хирургов и других медицинских работников по смежным специальностям.

Pancreatic necrosis is the most severe form of acute pancreatitis; which is accompanied by a high risk of developing serious complications such as sepsis; peritonitis; multiple organ failure; etc. The mortality rate of pancreatic necrosis reaches 60–80 %; according to many authors; representing a huge problem of emergency abdominal surgery. Pancreatic necrosis most often develops in young and middle-aged people; which makes it an important social problem. Despite recent advances in pancreatology; improvement of diagnostic methods; and the emergence of new treatment methods; difficulties in choosing the optimal treatment and diagnostic tactics for pancreatic necrosis remain.

In this review article; we analyzed new studies presented in open sources devoted to the diagnosis and treatment of acute pancreatitis. The search for scientific publications was conducted in the electronic database of the Scientific Library of Russia (eLibrary.ru) and the US National Library of Medicine (PubMed.org) in Russian and English. The following keywords were used as search queries: acute pancreatitis; pancreatic necrosis; ultrasound; CT; MRI; EUS; as well as their combinations in order to narrow the search for the problem. The article examines in detail the methods of radiation diagnostics of pancreatic necrosis (ultrasound; CT; MRI; EUS); which allow us to identify necrosis of the pancreatic parenchyma; the presence of “local” complications of acute pancreatitis and assess the severity. The authors analyze the advantages and limitations of each method; and discuss the features of interpreting the results. In particular; the role of radiological examination methods for assessing the severity of acute pancreatitis was studied in comparison with generally accepted scales: MCTSI; BISAP; APACHE-II; SOFA; Ranson and the C-reactive protein index. Data on diagnostic criteria for pancreatic duct disconnection syndrome were also systematized.

The article will be useful for specialists in the field of radiation diagnostics; surgeons and other medical workers in related specialties involved in the treatment of acute diseases of the pancreas.

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The authors declare that there are no conflicts of interest present.