| Title |
Ūminio nekrozinio pankreatito gydymo patirtis / |
| Translation of Title |
Experience in treating acute necrotic pancreatitis. |
| Authors |
Šileikis, Audrius ; Beiša, Virgilijus ; Jucevičius, Blažiejus ; Jurevičius, Saulius ; Tamošiūnas, Albinas ; Strupas, Kęstutis |
| DOI |
10.15388/LietChirur.2006.2.2276 |
| Full Text |
|
| Is Part of |
Lietuvos chirurgija.. Vilnius : Vilniaus universiteto leidykla. 2006, t. 4, Nr. 2, p. 154-160.. ISSN 1392-0995. eISSN 1648-9942 |
| Keywords [eng] |
acute pancreatitis ; pancreatic necrosis ; infection ; antibiotic prophylaxis |
| Abstract [eng] |
Background/objective. Acute pancreatitis is a disease which is notable for its complicated forecast of the clinical course and for its high degree of mortality. Thus, the goal of the present article is to reveal the accumulated experience in its treatment and to compare it with the data presented in the literature. Patients and methods. The medical documentation of 126 patients who underwent treatment against necrotics pancreatitis within the years 2002–2005 have been investigated by the retrospective method. Acute pancreatitis was diagnosed referring to the clinic, instrumental investigation and an increase of the quantity of amylase in the blood. The Atlanta clinical classification was applied seeking to ascertain the degree of severity. CT of the pancreas together with intravenous contrasting was employed to prove pancreatic necrosis. The patients were operated on, if infection of pancreatic necrosis was proved, if the intra-abdominal complication occurred or if the patient’s condition did not improve while continuing the conservative treatment for longer than three weeks. Debridment was done while operating on the patients; afterwards the open and closed packing was carried out. Results. Alcohol is the main cause of acute pancreatitis (48%). Pancreatic necrosis in most of the patients that had undergone treatment (69%) did not exceed 30% of the size of the pancreas. Most of the patients were operated on (57.14%). Infection of pancreatic necrosis served as the main indication for the operation (51.4%). The frequency of infection of pancreatic necrosis directly depended on the size of the necrosis. As regards the methods of operation, it was ascertained that there were less intestinal fistulas and duration of the post-operational treatment was shorter among the patients who had undergone the debridment followed by closed packing. Fifteen patients died (12%), of them seven died in the course of the first clinical phase and eight patients in the second phase. Conclusions: To avoid the complications caused by serious acute pancreatitis, which may be mortal, the timely diagnostics and the proper tactics of treatment are obligatory. While ascertaining the degree of severity of acute pancreatitis it is necessary to refer to the criteria adapted by the Atlanta Congress. Upon diagnosing pancreatic necrosis, it is advisable to prescribe antibiotics to prevent infection. The most optimal time for operational treatment is the 3rd or the 4th week after the onset of the disease. Patients ill with severe acute pancreatitis should be treated in the high-level centers in which their monitoring and an adequate correction of the complications will be assured. |
| Published |
Vilnius : Vilniaus universiteto leidykla |
| Type |
Journal article |
| Language |
Lithuanian |
| Publication date |
2006 |
| CC license |
|
