Clinical results of the complex prevention of the acute postoperative pancreatitis at the surgical gastroenterology

• Main Authors: Kotenko К.V., Voskanyan S.Е., Korsakov I.N., Naydenov Е.V., Timashkov D.A., Gavrilyuchenko R.B., Zhangazinov A.L., Sayapin D.A., Voronina I.V.
• Format: Article
• Language: Russian
• Published: Saratov State Medical University 2013-12-01
• Series: Саратовский научно-медицинский журнал
• Subjects: acute postoperative pancreatitis; duodenal enzyme inhibition; external drainage of the main pancreatic duct; intraduodenal reversion of pancreatic secret; parapancreatic microirrigation; prophylaxis
• Online Access: http://www.ssmj.ru/system/files/2013_04-01_962-968.pdf

The article aims to study the results of the complex prevention of the acute postoperative pancreatitis in the surgical gastroenterology. Material and methods. 2968 patients with various disorders of the digestive system were operated. Empirical preventing of the acute postoperative pancreatitis was used in the control group. Complex prevention of the acute postoperative pancreatitis in the main group of patients included the use of Dalargin, intravenous infusion of Octreotide, duodenal trypsin enzyme inhibition; intraduodenal reversal of pancreatic secret; intraductal injection of Lidocaine and external transnasal drainage of the pancreatic and biliary ducts. Results. The frequency of acute postoperative pancreatitis was 12.2% in the main group. The frequency of acute postoperative pancreatitis was 36.9% in the control group. Increased frequency of a mild form of the acute postoperative pancreatitis observed in the main group compared with the control. At the same time reducing the frequency of the moderate severity and severity forms of the acute postoperative pancreatitis observed in the main group compared with the control. Reduction of the morbidity (13.6% vs. 25.1%), hospital mortality (1.6% vs. 3.5%), the duration of the postoperative hospital bed-day (12.1±0.4 vs. 16.7±0.6) were identified in the main group patients compared with the control group. Conclusion. The use of the given scheme for the complex prevention of the acute postoperative pancreatitis allowed significantly reduce the frequency and severity of illness, morbidity, reduce the duration of postoperative hospital bed-day and hospital mortality, as well as the frequency of both mild and severity, and fatal postoperative complications in all investigated groups of patients.