EARLY CLINICAL MARKERS OF SEVERITY OF ACUTE NECROTIC PANCREATITIS

  • V. A. Syplyvy
  • V. I. Robak
  • D. V. Ievtushenko
  • V. O. Kurbatov
  • S. V. Grinchenko
  • L. O. Robak
Keywords: acute necrotic pancreatitis, clinical markers, severity, ASSES.

Abstract

Summary. Acute necrotic pancreatitis carries enough difficulty in diagnosis and treatment. Destructive forms with retroperitoneal tissue damage cause lethality up to 70 %.

The aim was to establish early clinical markers of disease severity.

Material and methods. The results of surgical treatment of 120 patients with acute pancreatitis were analyzed. Patients were divided into groups: first group – 40 patients without parapancreatitis; second group — 80 patients with parapancreatitis. Peripheral blood reaction, main biochemical indicators, blood electrolytes, general condition by integral scales were evaluated in this groups.

Results and discussion. On the admission day, the levels of erythrocytes and hemoglobin in patients in both groups were within normal limits. All patients had leukocytosis. All subjects had high LII rates. In the dynamics of treatment leukocytosis significantly decreased in the second group. Changes in clinical blood tests, urinalysis, ALT, AST, bilirubin, urea, creatinine were not significant.

Conclusions. Postoperative mortality was 27.2 %. 67 % of patients had parapancreatitis. It was revealed, that reliable early markers of severity of acute necrotizing pancreatitis are: level of WBC, leucocyte intoxication index, intoxication indicator, organism`s resistance index, reactive neutrophilic response, C-reactive protein and level of calcium. It was proved, that evaluation of patient`s condition by scales ASSES, SAPS II and Ranson objectively reflects the patient`s condition during the course of treatment.

References

1. Pandol S.J., Saluja A.K., Imrie C.W., Banks P.A. Acute pancreatitis: bench to the bedside. Gastroenterology. 2007;133:1056.e1–1056.e25.
2. Сипливий В.О., Петюнін О.Г., Робак В.І., Євтушенко Д.В., Драна Л.О. Хірургічне лікування гострого некротичного панкреатиту / Науково-практичний журнал «Art of Medicine», м. Івано-Франківськ, 2018; 155-157
3. Samuel I. Bile and pancreatic juice exclusion activates acinar stress kinases and exacerbates gallstone pancreatitis. Surgery. 2008;143:434–440.
4. Samuel I., Tephly L., Williard D.E., Carter A.B. Enteral exclusion increases MAP kinase activation and cytokine production in a model of gallstone pancreatitis. Pancreatology. 2008;8:6–14.
5. Сипливий В.О., Робак В.І., Євтушенко Д.В., Гузь А.Г., Петюнін О.Г. Досвід застосування улінастатіну в лікуванні пацієнтів із тяжким гострим панкреатитом. Український медичний часопис 6 (122) – XI/XII 2017
6. Сипливый В.А., Конь Е.В., Робак В.И., Евтушенко Д.В. Использование шкалы ASSES для оценки тяжести состояния больных и прогнозирования исхода острого панкреатита. Клiнiчна хiрургiя 2011; 32-35
7. Гострий панкреатит (Адаптована клінічна настанова, заснована на доказах) // Українська гастроентерологічна асоціація, Державний експертний центр Міністерства охорони здоровя України, 2016.
8. Le Campion E.R. Effects of intravenous administration of pentoxifylline in pancreatic ischaemia-reperfusion injury // HPB (Oxford). 2013 Aug;15(8):588-94.
9. Vege S.S. Pentoxifylline Treatment in Severe Acute Pancreatitis: A Pilot, Double-Blind, Placebo-Controlled, Randomized Trial // Gastroenterology. 2015 Aug;149(2):318-20
10. Патент України на корисну модель «Спосіб діагностики наявності гострого запального процесу». № 43305. Сипливий Василь Олексійович; Конь Катерина Володимирівна ; Робак Всеволод Ігорович; Євтушенко Дмитро Васильович від 24.03.2009. – бюл. №15.
Published
2020-04-20
How to Cite
Syplyvy, V. A., Robak, V. I., Ievtushenko, D. V., Kurbatov, V. O., Grinchenko, S. V., & Robak, L. O. (2020). EARLY CLINICAL MARKERS OF SEVERITY OF ACUTE NECROTIC PANCREATITIS. Kharkiv Surgical School, (2), 53-57. https://doi.org/10.37699/2308-7005.2.2020.11
Section
QUESTIONS OF SURGERY OF PANCREATOBILIARY SYSTEM

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