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The treatment of surgical patients with biliary tract diseases who also suffer from metabolic syndrome appears to be a complex task.This happens due to the time limit subject to the existence of obstructive jaundice and cholangitis the treatment of which are much more.complicated when metabolic syndrome exists.In order to discover the frequency,risk factors and preventive treatment efficiency of acute pancreatitis, retrospective and prospective analyses of transpapillaroperations based on the three trial sites of the Moscow Board of Health in 890 cases of obstructive jaundice and cholangitis from 2001 to 2011 have been performed.For the diagnostics and identification of the severity level of the primary disease and its comordity in addition to general clinical and biochemical research there have also been used ultrasound investigation of cavumabdominis, computer and MRT methods, phibrogastroduodenoscopy, selective angiography of celiac axis and retrograde cholangiopancreatography.The severity score was carried out using the scale APACHE-Ⅱ.Retrospective analysis of transpappilar interventions and their complications were carried out.12 patients (18%) out of 67 patients with acute destructive pancreatitis died.During the complications research of 67 patients with acute pancreatitis quite a large percentage of the patients-72% (48 patients) is represented by those who suffer from metabolic syndrome.For the prevention of acute pancreatitis after transpapillar interventions of the patients with metabolic syndrome the following scheme has been developed: 1.Predominantly liquid diet 3 days before the operation.2.Duspatalin 200 mg twice a day during 3 days before the operation.3.Losec 40 mg once a day during 3 days before the operation.4.Relanium 10 mg 1 time + Ocreotide 200 mg-12 hours before the research.5.Promedol 2%-1 ml +dimedrol 1%-1 ml-30 minutes before research.6.Relanium 10 mg +Methacin 0.1%-1 ml-on the surgical table.All the patients within 3 days after the operation were on antienzymes and fluroquinolone antibiotics.Due to the changes in the treatment schemes in pre-and post-transpapillar operations periods a drastic reduction in the number of pancreatitis cases of metabolic syndrome patients has been observed-8 (5.8%) out of 138 cases.In comparison with a control group of the patients being operated without using the scheme, the reduction of acute pancreatitis occurrence is 35% compared with 5.8% that is 6-fold decrease.The severity decrease of pancreatitis and mild state of the disease in the pharmaceutical treatment group was detected.The diastasuria level of the control group patients amounts to 820-11 000 Units (norm: < 430) which corresponds to the severe state of acute pancreatitis.The level of amilasemia is 245-2110 Units, the leucocytosis ranged from 9.8-24.6× 109 and was associated with the clinical signs of pancreatitis such as pain and intoxication syndromes.In the main group of the patients the severity of pancreatitis was less evident, the diatasuria was 92-1800 Units, amilasemia 26-149 Units, the leukocytosis did not exceed 12.2× 109.Pain syndrome was considerably less evident.