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abuse (34.8%), unknown cause (17.4%). According to the nature of the necrotic 
lesion, the mixed form was more common. 
Methods: 
In all patients, in addition to standard examination methods, the 
severity of the condition was assessed using the APACHE II scale. For dynamic 
control and early detection of organ dysfunction, a syndromic diagnostic algorithm 
was used, which included the SOFA scale, monitoring of endotoxemia, the 
functional state of the liver and kidneys, and intestinal failure syndrome. 
All patients were divided into two groups, identical in sex, age and pathology: 
group 1 - patients who were provided with extracorporeal detoxification 
(hemodiafiltration) as part of intensive care from the first day of the postoperative 
period (with APACHE - 21) as part of intensive care ( n = 8), group 2 (control group) 
– patients ( n = 6) who underwent standard management tactics in the postoperative 
period (full complex of treatment, but using the forced diuresis method , with A 
PACHE of about 20 and above). 
Extracorporeal detoxification was carried out on the apparatus Prismaflex 
(Gambro). Statistical processing was carried out using MS Ex programs from el 
2003, BioStat 8. 
Results: 
In the main group (Group 1), resolution of endotoxicosis and 
prevention of liver and kidney dysfunctions were carried out from the first day of 
the postoperative period using a set of measures, including: detoxification, 
prevention of intraabdominal hypertension syndrome, protection of mucous 
membranes, hepato- and nephroprotection. This made it possible to accelerate the 
elimination of endotoxicosis, reduce the time for normalization of homeostatic 
parameters of the body and the functioning of the organs of the detoxification-
metabolic system, including the liver and kidneys in group 1, compared with group 
2. 
The use of hemodiafiltration allowed in the postoperative period in patients 
with acute abdominal surgical pathology to reduce the percentage of hepatorenal 
dysfunctions and multiple organ failure, accelerated the normalization of motor-
evacuation and absorption activity of the intestine: the duration of its paresis in 
patients of group 1 was 1.6 ± 0.8 days compared with 2nd group 2.8 ± 1.2 days. 
Conclusions: 
The use of early detoxification tactics, including methods of 
extracorporeal detoxification, in patients with pancreatic necrosis can effectively 
eliminate endotoxin aggression and reduce the development of hepatorenal 
dysfunction. Also, early complex detoxification using methods that affect the main 
links in the pathogenesis of endotoxin aggression, active extracorporeal support for 
the function of the liver and kidneys before the development of decompensation and 
persistent loss of their performance, can improve the results of surgical treatment of 
patients with pancreatic necrosis. 

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