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Volkov V., Volkov S.
Diagnostics and Disease Management in Acute Postoperative Pancreatitis
Keywords: acute postoperative pancreatitis, etiologic factors, clinical features, diagnostics, complications, treatment, mortality
The article presents the results of treating acute postoperative pancreatitis in 55 patients who underwent different types of abdominal surgical procedures (total gastrectomy, partial gastrectomy, splenectomy, etc.) prior to development of this complication. The age of the patients enrolled ranged from 14 to 75 years. Oedematous pancreatitis was diagnosed in 13 patients, necrotizing pancreatitis – in 39 patients and purulent pancreatitis – in 3 patients. Out of the total of 55 patients 23 died (41,8%). The causes of fatal outcome were generalized peritonitis, purulonecrotic phlegmon of the retroperitoneal space, sepsis and septic shock, multi-organ system failure. It was established that early diagnosis of postoperative pancreatitis is not straightforward because clinical manifestations of this disorder may mimic other gastrointestinal pathologies such as stable paralytic ileus, generalized peritonitis due to anastomotic sutures’ leakage, perforation of acute stress ulcers etc. Acute postoperative pancreatitis is a severe and life threatening complication requiring comprehensive treatment including the use of fluid management, broad spectrum antibiotics, H2-receptor blockers, octreotide, corticosteroids as well as active surgical drainage of peripancreatic infected fluid and necrotic conglomerates.
References
- Volkov V.E., Volkov S.V. Opasnye posleoperatsionnye oslozhneniya v khirurgii [Severe postoperative complications in surgery]. Cheboksary, Chuvash University Publ., 2012, pp. 81–126.
- Volkov S.V. Gastrektomiya i ee posledstviya [Gastrectomy and its consequences]. Cheboksary, Chuvash University Publ., 2007, pp. 156–202.
- Katanov E.S. Ostryi posleoperatsionnyi pankreatit [Acute postoperative pancreatitis]. Cheboksary, Chuvash University Publ., 2000, 602 p.
- Chincarini M., Zamboni G.A., Pozzi Mucelli R. Major pancreatic resections: normal postoperative findings and complications. Insights Imaging, 2018, Apr., vol. 9, no. 2, pp. 173–187.
- Dedemadi G., Nikolopoulos M., Kalaitzopoulos I., Sgourakis G. Management of patients after recovering from acute severe biliary pancreatitis. World J. Gastroenterol., 2016, Sep. 14, vol. 22, no. 34, pp. 7708–7717.
- Mulholland M.W., Doherty G.M. Complicatios in Surgery. Philadelphia, Baltimor, New York, 2006, pp. 463–476.
- Wang Y.B., Yang X.L., Chen L., Chen Z.J., Miao C.M., Xia J. Retroperitoneal versus open intraperitoneal necrosectomy in step-up therapy for infected necrotizing pancreatitis: A meta-analysis. J. Surg., 2018, Aug., vol. 56, pp. 83-93.
About authors
- Volkov Vladimir
- Doctor of Medical Sciences, Professor, Head of Surgical Diseases Department, Chuvash State University, Russia, Cheboksary (volkovserguei@mail.ru; )
- Volkov Sergey
- Doctor of Medical Sciences, Professor of Surgical Diseases Department, Chuvash State University, Russia, Cheboksary (volkovserguei@mail.ru; )
Article link
Volkov V., Volkov S. Diagnostics and Disease Management in Acute Postoperative Pancreatitis [Electronic resource] // Acta medica Eurasica. – 2019. – №2. P. 9-15. – URL: https://acta-medica-eurasica.ru/en/single/2019/2/2/.