ISSN 2415-3060 (print), ISSN 2522-4972 (online)
  • 15 of 42
Up
JMBS 2017, 2(4): 87–90
https://doi.org/10.26693/jmbs02.04.087
Clinical Medicine

Treatment Tactic in Patients with Local Infected Pancreonecrosis

Maksymiuk V. V., Tarabanchuk V. V., Baranetskiy F. I.
Abstract

The article deals with a complex estimation of efficiency of offered approaches carried out to optimize the treatment tactics of patients with local infected pancreonecrosis. Methods: 28 patients with local infected pancreonecrosis took part in the research. The control group included 13 patients. The experimental group consisted of 15 patients, who used the developed approaches to optimization of treatment tactics. The presence of infection with pancreatic necrosis was determined by the positive results of microbiological studies of the affected tissues, the content of fluid formations (fluid collection, abscess, pseudocysts) and peritoneal fluid, which was collected during surgical invasions (puncture, videolaparoscopy, laparotomy). The statistical relationship between the values of the obtained indicators was checked by determining the criteria of Student, Fisher and Pearson. Results: In the comparative evaluation of the treatment results, it was found that the incidence of complications from the surgical wound in patients with the main group was 15.0% (3 – suppuration), which was significantly lower than that in the control group – 57.1% (6 – suppuration, 2 – eventeration) (χ2 = 4.896, p = 0.027). The average duration of inpatient treatment of patients in the experimental group was 41.20 ± 2.37 days in bed and was significantly lower than in the control group – 49.18 ± 3.23 days in bed (p <0.05). There were no deaths in patients from both groups. Conclusions: The results of the research show that the application of the proposed approaches to the optimization of surgical tactics and complex treatment of patients infected with pancreonecrosis allowed to reduce the number of postoperative wound complications by 42.1% and to shorten the duration treatment of patients in average of 8 days.

Keywords: local infected pancreonecrosis, treatment tactic

Full text: PDF (Ukr) 188K

References
  1. Petrushenko VV, Pashynskyi YaM, Sobko VS, Khodakivskyi SV. Mistse terminovoi endoskopichnoi papilosfinkterotomiyi u kompleksnomu likuvanni gostrogo pankreatytu ta yogo uskladnen. Visnyk Vinnytskogo natsionalnogo medychnogo universytetu. 2014; 18 (2): 181-3. [Ukrainian].
  2. Shaprynskyi VO, Komarovskyi MS. Etapnyi pidkhid do vyboru antybakterialnoi terapiyi v likuvanni perytonitu. Klinichna anatomiya ta operatyvna khirurgiya. 2014; 13 (1): 68-70. [Ukrainian].
  3. Waele D, Jan J. Acute pancreatitis. Current Opinion in Critical Care. 2014; 20 (Iss 2): 189-95. https://doi.org/10.1097/MCC.0000000000000068
  4. De Waele Jan J, Hoste E, Blot SI , Decruyenaere J, Francis C. Intra-abdominal hypertension in patients with severe acute pancreatitis. Critical Care. 2005; 9: R452. https://doi.org/10.1186/cc3754
  5. Gecelter G, Fahoum B, Gardezi S, Schein M. Abdominal compartment syndrome in severe acute pancreatitis: an indication for a decompressing laparotomy? Dig Surg. 2002; 19 (5): 404-5. https://www.ncbi.nlm.nih.gov/pubmed/12435913. https://doi.org/10.1159/000065820
  6. Klinichni protokoly nadannya medychnoi dopomogy khvorym z gostrymy zapalnymy zakhvoryuvannyamy cherevnoi porozhnyny: Normatyvnyi dokument Ministerstva okhorony zdorov’ya Ukrainy. Nakaz MOZU №297: Pro zatverdzhennya standartiv ta klinichnykh protokoliv nadannya medychnoi dopomogy zi spetsialnosti “Khirurgiya”. 2010. s. 69-85. [Ukrainian].
  7. Udoskonaleni algorytmy diagnostyky ta likuvannya gostrogo pankreatytu: metodychni rekomendatsiyi. Normatyvnyi dokument Ministerstva okhorony zdorov’ya Ukrainy. Uporyad ta golov red PD Fomin. K, 2012. 80 s. [Ukrainian].