Conservative approach in the management of severe acute pancreatitis: eight-year experience in a single institution

Pupelis, Guntars; Zeiza, K.; Plaudis, Haralds; Suhova, Anastasija

doi:10.1080/13651820802140737

Cited by 21 publications

(14 citation statements)

References 40 publications

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“…This was comparable to the study by Pupelis G et al 6 In the other studies gall stone was the main etiological factor. The percentage of idiopathic cases was comparable.…”

Section: Figure 12supporting

confidence: 92%

Clinical Study on Acute Pancreatitis

A¹,

Chandrashekhar²,

J³

2015

jemds

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INTRODUCTION:Early diagnosis and severity evaluation on patients with acute pancreatitis are very important due to its potential morbidity and mortality. Given the wide spectrum of disease seen, the care of patients with pancreatitis must be highly individualized. Several clinical, laboratory and radiologic factors and many scoring systems have been proposed for outcome prediction. AIMS AND OBJECTIVES: To study the symptomatology, clinical presentation and management in pancreatitis. To study the severity of acute pancreatitis according to Glasgow Scale. METHODS: Present study includes consecutive 38 patients hospitalized in CSI Holdsworth Memorial Hospital over the period of 2 years. All patients were thoroughly investigated and were stratified according to the Glasgow criteria. Data was collected on complications, investigations and interventions undertaken, outcome, duration of stay in hospital and ICU. STATISTICAL ANALYSIS USED: Descriptive, Chi square tests, Crosstabs (Contingency coefficient analysis). RESULTS: Mean age of presentation in our study was 43.1 years. There was a male predominance accounting for 68.4% compared to 31.6% females. Alcohol was the main etiological factor in about 50% of the patients. Sensitivity to S. amylase was about 100%. Accuracy of USG abdomen in diagnosing pancreatitis was about 88.5%. Ascitis was the commonest complication seen in 13.2%. Mean duration of hospital stay was 6.2 days. The patient were stratified according to Glasgow scoring system into mild (0-3) and severe (>3) pancreatitis. In our study 32 people were graded with mild pancreatitis, all improved and in 6 people who were graded with severe pancreatitis, 83.3 % improved and 2.6% expired because of complications. Test statistics showed Contingency coefficient 0.355 and P 0.019 (NS). CONCLUSION: Glasgow scoring system remains a valid predicting system for the outcome in patients with acute pancreatitis. It is simple easy to apply with good predictive value and can be used in all hospital settings.

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“…This was comparable to the study by Pupelis G et al 6 In the other studies gall stone was the main etiological factor. The percentage of idiopathic cases was comparable.…”

Section: Figure 12supporting

confidence: 92%

Clinical Study on Acute Pancreatitis

A¹,

Chandrashekhar²,

J³

2015

jemds

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“…Table 3 shows the three main aetiologies of acute pancreatitis (alcohol, gallstone and other or idiopathic aetiology) reported from studies across Europe. Of 11 studies from eastern Europe, seven (64%) had a higher ratio of alcohol to gallstone aetiologies [10,[24][25][26][27][28]77], which is significantly higher than for two of 16 studies from southern Europe (13%; p=0.012) [8,30], and for three of 21 studies from northern Europe (14%; p=0.013) [29,31], although not significantly different to three of nine studies from western Europe (33%; p=0.37) [28,32].…”

Section: Incidence Of Acute Pancreatitis Across Europementioning

confidence: 94%

“…Studies that reported the highest ratios of gallstone to alcohol acute pancreatitis of more than six to one are solely from southern European Mediterranean countries, Greece [28], Turkey [33], and Italy [34,35], while studies with the lowest ratios of gallstone to alcohol aetiology of 9 less than 0.5 to one are mainly from eastern European countries, Hungary [28], Latvia [26], and Romania [25], along with Finland [31].…”

Section: Aetiology Of Acute Pancreatitis Across Europementioning

confidence: 99%

The incidence and aetiology of acute pancreatitis across Europe

et al. 2017

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“…Thus, efficient management of SAP is very important. Evidence accumulated over the last years demonstrate that continuous venovenous hemofiltration (CVVH) is of benefit for SAP, because of its removal of inflammatory molecules (6–8). Particular attention has been paid to high‐volume hemofiltration (HVHF), which might be better (9).…”

mentioning

confidence: 99%

Clinical Effects of Pulse High‐Volume Hemofiltration on Severe Acute Pancreatitis Complicated With Multiple Organ Dysfunction Syndrome

Chu¹,

Jun-jing²,

Yu³

et al. 2012

Ther Apher Dial

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To evaluate the effects of pulse high-volume hemofiltration (PHVHF) on severe acute pancreatitis (SAP) with multiple organ dysfunction syndrome (MODS). Thirty patients were divided into two groups: PHVHF group and continuous venovenous hemofiltration (CVVH) group. They were evaluated in terms of clinical symptoms, acute physiology and chronic health evaluation (APACHE) II score, sequential organ failure assessment (SOFA) score, simplified acute physiology (SAPS) II score and biochemical changes. The levels of IL-6, IL-10 and TNF-α in plasma were assessed by ELISA before and after treatment. The doses of dopamine used in shock patients were also analyzed. In the two groups, symptoms were markedly improved after treatment. Body temperature (BT), breath rate (BR), heart rate (HR), APACHE II score, SOFA score, SAPS II score, serum amylase, white blood cell count and C-reactive protein were decreased after hemofiltration (P < 0.05). The PHVHF group was superior to the CVVH group, especially in APACHE II score, CRP (P < 0.01), HR, temperature, SOFA score and SAPS II score (P < 0.05). The doses of dopamine for shock patients were also decreased in the two groups (P < 0.05), with more reduction in the PHVHF group than the CVVH group (P < 0.05). The levels of IL-6, IL-10 and TNF-α decreased (P < 0.05) in the PHVHF group more significantly than the CVVH group (P < 0.01). PHVHF appears to be superior to CVVH in the treatment of SAP with MODS.

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Conservative approach in the management of severe acute pancreatitis: eight-year experience in a single institution

Abstract: The conservative protocol-based approach is a rational treatment strategy for the management of SAP and can be successfully implemented in the setting of the university hospital.

Cited by 21 publications

References 40 publications

Clinical Study on Acute Pancreatitis

Clinical Study on Acute Pancreatitis

The incidence and aetiology of acute pancreatitis across Europe

Clinical Effects of Pulse High‐Volume Hemofiltration on Severe Acute Pancreatitis Complicated With Multiple Organ Dysfunction Syndrome

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