Priority directions in the treatment of patients with acute pancreatitis

Ya.M. Pidhirny, B.Ya. Pidhirny

Abstract


Background. The paper analyses the strategic directions in the intensive care of acute severe pancreatitis. The purpose was to determine the priority directions of the intensive care and surgery in patients with acute pancreatitis to prevent the systemic complications of the disease as well as infection in case of developed necrosis of the pancreas and parapancreatic lumen. Materials and methods. A total of 32 patients were examined (10 female and 22 males) who were admitted to Lviv Regional Clinical Hospital with the diagnosis of acute pancreatitis in the period of 2014–2017. The causes of acute pancreatitis included gallstone disease and microlithiasis in 18 patients, alcohol abuse — in 12, and idiopathic pancreatitis in 2 persons. Results. It has been stated reasonable to carry out the infusion therapy considering the term of the disease. The surgical interventions were performed two or three weeks after the onset of the disease that is the most common period of contamination in the necrotic focuses and demarcation of the necrotic sites. Methods of minimally invasive draining of destructed regions were dominant if it was possible. The effectiveness of all antiprotease medications has been proved as incomplete. The increase of the C-reactive protein and procalcitonin levels indicate the need for antibio­tic therapy. Conclusions. The treatment of patients with acute pancreatitis requires the application of multidisciplinary approach engaging anesthesiologists, surgeons, bacteriologists, radiologists and other specialists. The decisions of each medical professional have to be prioritized at certain therapeutic stages.

Keywords


acute pancreatitis; infusion and antibacterial therapy; antiprotease medications

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DOI: https://doi.org/10.22141/2224-0586.3.90.2018.129485

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