Influence of enzymatic parapancreatitis on the early phase of acute destructive pancreatitis
https://doi.org/10.24884/1607-4181-2020-27-3-29-33
Abstract
Introduction. One of the most significant components of acute destructive pancreatitis (ADP) is enzymatic parapancreatitis (EP). The severity of the defeat of the retroperitoneal tissue from the early stages of the disease largely determines its course.
The objectivewas to assess the features of the evolution of the pathological process in the retroperitoneal tissue in ADP and the effect of EP on the course of phase I of ADP.
Methods and materials. 63 cases (ADP) without enzymatic peritonitis were analyzed. The average age of patients was (46.6±3.2) years (p≤0.05). The sum of points according to the express diagnostic scale of the SPb I. I. Dzhanelidze RIEM was (3.7±0.2) points (p≤0.05). The average time from the onset of the disease to the start of therapy was 2 days (from 7 to 1 day).
Results. Types of EP at admission were distributed as follows: type B – 17.5 % (n=11) of cases, type C – 44.4 % (n=28) of cases, type D – 30.2 % (n=19) of cases, type E – 7.9 % (n=5) of cases. Spearman’s rank correlation coefficient for assessing the relationship between the severity of the condition and the type of parapancreatitis was 0.069. Infiltrative parapancreatitis (IP) was formed in 93.4 % of cases. The types of infiltrative parapancreatitis (pancreatic infiltrate) were distributed as follows: type A – 12.3 % (n=7) of cases, type B – 21.1 % (n=12) of cases, type C – 36.8 % (n=21) of cases, type D – 19.3 % (n=11) of cases, type E – 10.5 % (n=6) of cases. There was a pronounced relation between the severity of the patient’s condition and the prevalence of IP, the Spearman’s rank correlation coefficient was 0.82.
Conclusions. EP is formed in most cases of acute destructive pancreatitis and is evolutionary. It has a significant effect on the severity of the patient’s condition and the course of acute destructive pancreatitis in the infiltrative phase of the disease.
About the Authors
D. V. Kulikov
Pavlov University
Russian Federation
Competing Interests:
Russian Federation
Kulikov Dmitrii V., Surgeon, Full-time Postgraduate Student of the Department of General Surgery
6-8, L’va Tolstogo str., Saint Petersburg, 197022
Competing Interests:
Authors declare no conflict of interest.
The authors confirm that they respect the rights of the people participated in the study, including obtaining informed consent when it is necessary, and the rules of treatment of animals when they are used in the study. Author Guidelines contains the detailed information.
A. Yu. Korolkov
Pavlov University
Russian Federation
Competing Interests:
Russian Federation
Korolkov Andrey Yu., Dr. of Sci. (Med.), Associate Professor of the Department
of Hospital Surgery № 1, Head of the Department of General and Emergency Surgery of the Research Institute for Surgery and Emergency Medicine
Saint Petersburg
Competing Interests:
Authors declare no conflict of interest.
The authors confirm that they respect the rights of the people participated in the study, including obtaining informed consent when it is necessary, and the rules of treatment of animals when they are used in the study. Author Guidelines contains the detailed information.
References
1. Antipin V. F., Gudarchenko N. V., Kuzmin S. V. Acute pancreatitis and assessment of the severity of the condition in the system of multivariate criteria. Materials of the VI Interregional Scientific and Practical Conference “Togliatti autumn – 2013”. Togliatti, 2013:13–14. (In Russ.).
2. Bagnenko S. F., Goltsov V. R., Savello V. E., Vashetko R. V. Classification of acute pancreatitis: current state of the problem. Grekov’s Bulletin of Surgery. 2015;174(5):86–92. (In Russ.).
3. Pugaev A. V. Acute pancreatitis. Moscow, Profil, 2007: 335. (In Russ.).
4. Shelest P. V., Mironov V. I. Diagnostics and prognosis of clinical and morphological forms of acute destructive pancreatitis. Siberian Medical Journal. 2007;6(5):9. (In Russ.).
5. Bagnenko S. F., Rukhlyada N. V., Tolstoy A. D. et al. Treatment of acute pancreatitis at an early stage of the disease: Proc. Allowance. The Saint Petersburg Research Institute of Emergency Medicine n. a. I. I. Dzhanelidze. St. Petersburg, 2002:24. (In Russ.).
6. Daila M. M., Foromena J. K. A Guide to Immunopharmacology. Moscow, Medicine, 1998:332. (In Russ.).
7. Ermolov A. S. Immunological assessment of severity and prognosis of acute pancreatitis. Grekov’s Bulletin of Surgery. 2005;6:22–28. (In Russ.).
8. National clinical guidelines for acute pancreatitis 2015. Chairman M. D. Dibirov, S. F. Bagnenko, D. A. Blagovestnov, E. I. Galperin, T. G. Dyuzheva, M. I. Prudkov, M. I. Filimonov, A. V. Zhao. 2015:9. (In Russ.). Available at: http://общество-хирургов.рф/stranica-pravlenija/unkr/urgentnaja-abdominal-naja-hirurgija/nacionalnye-klinicheskie-rekomendaci-po-ostromu-pankreatitu.html (accessed 12.08.2020).
9. Shugaev A. I., Kaisarov V. R., Mosoyan S. S. et al. Topographic and anatomical features of «parapancreal» cellular spaces and pathways of the pathological process in acute destructive pancreatitis. Grekov’s Bulletin of Surgery. 2005;5:26–30. (In Russ.).
10. Tolstoy A. D., Panov V. P., Krasnorogov V. B. Parapancreatitis (etiology, pathogenesis, diagnosis, treatment). St. Petersburg, Clear Light, 2003:7. (In Russ.).
11. Gotzinger P. Surgical treatment for severe acute pancreatitis: extent and surgical control of necrosis determine outcome. World. J. Surg. 2009;26(4):474–478. Doi: 10.1007/s00268-001-0252-8.
12. Vashetko R. V. Morphology of local and general pathological processes in acute pancreatitis: Diss. Dr. med. Science. St. Petersburg, 1993:348. (In Russ.).
Review
For citations:
Kulikov D.V., Korolkov A.Yu. Influence of enzymatic parapancreatitis on the early phase of acute destructive pancreatitis. The Scientific Notes of the Pavlov University. 2020;27(3):29-33. (In Russ.) https://doi.org/10.24884/1607-4181-2020-27-3-29-33
Views:
929
Email this article 