scholarly journals STRUCTURAL ANALYSIS OF CLINICAL AND LABORATORY AND INSTRUMENTAL DIAGNOSIS AND TREATMENT OF ACUTE PANCREATITIS

2021 ◽  
pp. 52-58
Author(s):  
M. I. Pokidko ◽  
T. V. Formanchuk ◽  
A. G. Sychevska ◽  
O. B. Tkachenko
Keyword(s):  
Acute Pancreatitis ◽  
Surgical Treatment ◽  
Severe Acute Pancreatitis ◽  
Abdominal Cavity ◽  
Early Period ◽  
Total Mortality ◽  
Infusion Therapy ◽  
Intravenous Contrast ◽  
Postoperative Pancreatitis ◽  
Overall Mortality

Summary. The purpose of the study: to analyze the causes of development, terms of hospitalization, the frequency of severe type, complications and overall mortality in acute pancreatitis according to the clinic data. Materials and methods: the results of treatment of 622 patients with acute pancreatitis were analyzed. Among them there were 336 women (54.1 %) and 286 men (45.9 %). The mean age of patients was (48.2 ± 2.2) years. The diagnosis of acute pancreatitis was made according to the recommendations (Atlanta, 2012). All patients with acute pancreatitis underwent ultrasound examination of the abdominal cavity and computed tomography, enhanced by intravenous contrast. Results and discussion: Etiological factors of acute pancreatitis were: biliary factor in 270 (43.4 %) patients, alcohol — in 155 (24.9 %), acute pancreatitis on the background of triglyceridemia — in 135 patients (21.7 %), 21 (3.4 %) patients had postoperative pancreatitis, medication — in 8 (1.3 %) patients and without a clear etiology — in 33 (5.3 %) patients. The terms of hospitalization of patients are as follows: after 24–48 hours from the onset of the disease — 215 (34.6 %) cases, after 6–24 hours after the onset of the disease — 204 (32.8 %) cases, after 48 hours and later from the time of the disease — 129 (20.7 %) cases and 74 (11.9 %) cases of hospitalization up to 6 hours from the onset of the disease. Severe acute pancreatitis developed in 147 (23.6 %) patients and was accompanied by the development of organ failure lasting > 48 hours. 594 (95.4 %) patients with acute pancreatitis received only conservative infusion therapy. 28 (4.5 %) patients required surgical treatment. The overall mortality in patients with acute pancreatitis was 9 (1.4 %) cases. Conclusions: Hyperdiagnosis of acute pancreatitis is a common problem in modern surgery. Formulation of the diagnosis according to the unified diagnostic criteria considerably facilitated diagnosis. The dominant factors of acute pancreatitis are biliary (43.4 %) and alcoholic factors (24.9 %). Most often (34.6 %) patients were admitted to the department on the second day after the onset of the disease. Remains high level of severe acute pancreatitis, which amounted to 23.6 % of cases. 594 (95.4 %) patients with acute pancreatitis received infusion therapy. 28 (4.5 %) patients underwent surgical treatment. The total mortality in acute pancreatitis according to our clinic was 9 (1.4 %) cases, the majority of them (7 patients) died in the early period of acute pancreatitis.

PROBLEMS IN THE SURGICAL TREATMENT OF SEVERE ACUTE PANCREATITIS

Pancreas ◽  
2007 ◽  
Vol 35 (1) ◽  
pp. 88-89
Author(s):  
Yoshifumi Takeyama ◽  
Yasuyuki Kihara ◽  
Makoto Otsuki
Keyword(s):  
Acute Pancreatitis ◽  
Surgical Treatment ◽  
Severe Acute Pancreatitis

scholarly journals ASSESSMENT OF THE EFFICIENCY OF TREATMENT ASCITES-PERITONITIS IN PATIENTS WITH SEVERE ACUTE PANCREATITIS

2019 ◽  
Vol 19 (3) ◽  
pp. 48-51
Author(s):  
V.V. Kasian
Keyword(s):  
Acute Pancreatitis ◽  
Enteral Nutrition ◽  
Randomized Clinical Trials ◽  
Early Period ◽  
Total Mortality ◽  
Postoperative Mortality ◽  
Pain Syndrome ◽  
Apache Ii ◽  
Positive Effects ◽  
Initial Severity

The incidence of acute pancreatitis in Ukraine is 102 per 100,000 of the population, the total mortality rate ranges from 4% to 15%, and with necrotic form it is 24-60%, postoperative mortality reaches 70%. To date, randomized clinical trials and publications show conflicting data on the effectiveness of surgical interventions in acute pancreatitis complicated by ascites-peritonitis. The aim of the work was to analyze the effect of drainage interventions on the intensity of the pain syndrome and the dynamics of restoration of enteral nutrition in acute pancreatitis complicated by ascites-peritonitis. The study analyzed the results of a comprehensive examination and treatment of 166 patients with acute necrotic pancreatitis with enzymatic ascites-peritonitis. In patients with an initial severity of the condition rated on the APACHE II scale as 5 or more points, a positive effect of draining interventions at the start of treatment of acute pancreatitis was observed compared with non-drained patients of similar severity at the time of hospitalization, which was manifested by the disappearance of pain and restoration of self-enteral nutrition after 72 hours in most patients of these subgroups. Therefore, the elimination of enzymatic ascites can reliably reduce the intensity of the pain syndrome and contribute to the restoration of independent enteral nutrition and can be recommended for consideration as an element of the complex treatment of acute pancreatitis complicated by ascites-peritonitis in patients with the initial severity of the condition rated on the APACHE II scale as 5 or more points. Further studies are needed to study other possible positive effects of drainage interventions and determine clear indications for their conduct in the early period of the disease.

scholarly journals COMPARISON OF DIAGNOSTIC METHODS AND TREATMENT OF ENDOMETRIOSIS OF ATYPICAL LOCATION

2018 ◽  
Vol 5 (3) ◽  
pp. 157-163
Author(s):  
D. D Shlyk ◽  
Yury E. Kitsenko ◽  
D. R Markaryan ◽  
V. I Lanchinskiy ◽  
I. A Tulina ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Abdominal Cavity ◽  
Malignant Neoplasm ◽  
Early Postoperative Period ◽  
Diagnostic Methods ◽  
Reproductive Age ◽  
Treatment Technique ◽  
Intravenous Contrast ◽  
Preoperative Stage ◽  
Extragenital Endometriosis

Surgical treatment and subsequent management of women of reproductive age with endometriosis of extragenital localization involving intestine, whose frequency is up to 37%, currently do not have a detailed and clearly described protocol, which may be caused by the complexity of diagnosis at the preoperative stage. In most cases, extragenital localization is an intraoperative finding. The purpose of the article is to evaluate the complexity of diagnosing the atypical location of extragenital endometriosis, systematize the diagnostic protocol and present the chosen treatment tactics. Material and methods. In the clinic of coloproctology and minimally invasive surgery, 4 observations of extragenital endometriosis with intestinal lesions were noted. According to the results of diagnostic studies (multispiral computed tomography - MSCT of the abdominal cavity with intravenous contrast, irrigoscopy with double contrasting, colonoscopy with biopsy), endometriosis was confirmed in 2 patients at the preoperative stage. All patients underwent surgical interventions in the volume of resection of the affected segment of the intestine within the unchanged tissues. Results. According to the intraoperative revision, in all patients there was noted the presence of additional extragenital foci of different localization, which were destroyed by diathermocoagulation. Patients with unverified endometriosis also underwent lymphadenectomy in D2 volume due to the inability to exclude malignant neoplasm. In the early postoperative period, no complications were noted. Only 1 patient decided to take hormonal therapy for 6 months after the operation. At present, none of the relapses have been observed, the mean follow-up time is 17.3 ± 13.6 months (4-33 months). In all patients there was recovered the menstrual cycle, menstruation moderately painful, previous abdominal pains before menstruation and spotting discharges from the rectum stopped. Conclusion. Surgical treatment of extragenital endometriosis of intestinal localization in the volume of resection of the affected intestine within the unchanged tissues is the optimal treatment technique and is not accompanied by significant complications. However, in cases of unverified histologically endometriosis, principles of oncological radicalism should be kept. To select the optimal volume of surgical intervention and access, a multidisciplinary consultation with the coloproctologist, gynecologist and with the obligatory consideration of the patient’s opinion is required.

scholarly journals Diagnosis and treatment of destructive forms of acute pancreatitis

2019 ◽  
Vol 41 part 1 (2) ◽  
pp. 65-70
Author(s):  
V. V. Mishchenko ◽  
V. V. Hrubnyk ◽  
P. I. Pustovoyt ◽  
V. V. Horyachyy ◽  
V. V. Velychko ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Abdominal Cavity ◽  
Secretory Activity ◽  
Multiple Organ ◽  
Diagnosis And Treatment ◽  
Infusion Therapy ◽  
Surgical Interventions ◽  
Purulent Peritonitis ◽  
Peridural Anesthesia ◽  
Complete Cell

Purpose of the study. The study of the diagnosis and treatment of destructive forms of acute pancreatitis and the identification of possible ways to optimize them. Materials and methods. Destructive forms of acute pancreatitis were found in 16,8%. The algorithm for treating acute destructive pancreatitis consisted in artificial ventilation of the lungs, adequate infusion therapy, peridural anesthesia, setting up a nasoenteric probe, stimulating the bowels, correcting hemodynamics, intra- and extracorporal detoxification, antisecretory, anti-bacterial, hepatoprotective, cerebroprotective, antioxidant therapy, directed immune correction, use of anti-enzyme drugs, suppression of the release of mediators inflammation, external secretory activity of the pancreas. Medical video laparoscopy and puncture interventions under the control of ultrasound were used as the first stage of surgical treatment. The indications for traditional surgical interventions are large areas of aseptic destruction, unlimited infected pancreatic necrosis, infection of necrotic areas with complete cell sequestration, abscesses with large sequesters, abdominal phlegmon, signs of progressive multiple organ failure and the development of arousal hemorrhage, perforation of cystic formations in the abdominal cavity, perforation of a hollow organ, purulent peritonitis. Results. The developed therapeutic tactics allowed, in destructive forms of acute pancreatitis, to achieve a reduction in overall mortality to 23,4%. Conclusion. Diagnostic and treatment tactics for destructive forms of acute pancreatitis should be standardized depending on the timing, severity of the disease, localization and prevalence of the destructive process, systemic and local complications. Keywords: acute, destructive, pancreatitis, diagnosis, treatment.

scholarly journals Surgical treatment of severe acute pancreatitis: After 15 years of practice

2015 ◽  
Vol 5 ◽  
pp. 74
Author(s):  
Jorge Pereira ◽  
Júlio Constantino ◽  
Liliana Duarte ◽  
Helena Pinho ◽  
Luis Pinheiro
Keyword(s):  
Acute Pancreatitis ◽  
Surgical Treatment ◽  
Severe Acute Pancreatitis

Surgical Treatment of Severe Acute Pancreatitis: Timing of Operation is Crucial for Survival

2003 ◽  
Vol 4 (2) ◽  
pp. 205-211 ◽  
Author(s):  
Peter Götzinger ◽  
Peter Wamser ◽  
Ruth Exner ◽  
Erhard Schwanzer ◽  
Raimund Jakesz ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Surgical Treatment ◽  
Severe Acute Pancreatitis ◽  
Timing Of Operation

Long-Term Results and Quality of Life of Patients Undergoing Sequential Surgical Treatment for Severe Acute Pancreatitis Complicated by Infected Pancreatic Necrosis

2006 ◽  
Vol 7 (supplement 2) ◽  
pp. s-113-s-116 ◽  
Author(s):  
Lorenza Cinquepalmi ◽  
Luigi Boni ◽  
Gianlorenzo Dionigi ◽  
Francesca Rovera ◽  
Mario Diurni ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Acute Pancreatitis ◽  
Surgical Treatment ◽  
Severe Acute Pancreatitis ◽  
Pancreatic Necrosis ◽  
Infected Pancreatic Necrosis ◽  
Long Term Results
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