EXPERIENCE IN THE TREATMENT OF PATIENTS WITH SEVERE ACUTE PANCREATITIS

Zavgorodnii S. N., Rylov A. I., Kubrak M. A., Danyluk M. B., Yareshko N. A.

CLINICAL AND EXPERIMENTAL MEDICINE

Scentific article

Patients with acute pancreatitis account for 9-17% of the total number of patients surgical. Overall mortality in this disease varies from 4.5 to 15%, in destructive forms – is growing to 24-60%, and postoperative reaches 70% or above and has no tendency to decline. In 2013 IAP (International Association of Pancreatology) together with the APA (American Pancreatic Association) has developed clinical practice guidelines for the treatment of patients with acute pancreatitis, which allow you to change approaches to the management of patients with severe pancreatitis. The purpose of the study. To evaluate the results of treatment of patients with acute pancreatitis severe after the application of clinical guidelines IAP\APA. Object and methods. A retrospective analysis of 74 medical records of patients admitted in the 1st surgical Department UI “CCH of E and A c. Zaporozhye” with the diagnosis of acute pancreatitis severe severity levels for the period from 2012 to 2017. Results and discussion. All patients were divided into 2 groups – basic and control group. The study group included 33 (44,6%) patients with acute pacreatitis severe, the treatment which applied the recommendations of the IAP\APA. In the comparison group (41 (55,4%) of patients) included patients with severe acute pancreatitis who were treated according to the standards and clinical guidelines approved by the Ministry of health (order № 297, 02.04.2010 g). The analysis of the data additional laboratory and instrumental methods of research, methods and effektivnosti treatment of patients in these groups. Conclusions. 1. Acute pancreatitis is a severe surgical pathology which requires development of new approaches to its treatment. 2. The application of guidelines developed by the IPA\APA, allows to improve the results of treatment of patients with severe acute pancreatitis severity, reduce the duration of patients’ stay in hospital (12,6 ± 3,8 days, compared with 19,4 ± 4,1 days if interstitial pancreatitis, p < 0,05; Of 19,6 ± 7.8 days, compared to 26,4 ± 9,1 days with necrotic pancreatitis, p < 0,05) and thereby reduces the material costs for the treatment of this group of patients. 3. Application of these recommendations has helped to reduce the level of lethal outcomes in patients with necrotizing pancreatitis from 33,3% to 8,3%, p < 0.01.

acute pancreatitis, severe pancreatitis, conservative management, research methods, recommendations IPA\APA

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«Bulletin of problems biology and medicine» Issue 4 Part 3 (141), 2017 year, 126-132 pages, index UDK 616.37-002-036.1-089

10.29254/2077–4214–2017–4–3–141–126-132