medigraphic.com
Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado

2008, Number 1

<< Back Next >>

Rev Esp Med Quir 2008; 13 (1)

Experience on surgical management of patients with severe acute pancreatitis at Regional Hospital General Ignacio Zaragosa, ISSTE

Castañeda RCA, Reinoso ERA

Language: Spanish
References: 12
Page: 18-23
PDF size: 167.33 Kb.


ABSTRACT

Objective: To describe the different kind of surgery procedures used in 41 patients in five years period with acute severe pancreatitis that required surgery, as well as their evolution and outcome.
Material and methods: An observational, transversal, retrospective, comparative and open study was done including patients with severe acute pancreatitis admitted at General Surgery Service, Hospital Regional General Ignacio Zaragoza for a 5-year-period, who required surgical treatment. Patients with chronic pancreatitis, biliopancreatic cancer and pancreas congenital malformations were excluded.
Results: Eighteen patients needed surgical reintervention. With an average of 3.16 surgical times, there was no difference in survival between using the open management and the continuous irrigation/drainage system. Only two patients were placed a Tenchkoff catheter for peritoneal lavage and favorable outcome, the mortality was 39.53%. Twenty-three of the 41 patients left the hospital for improvement of their health status.
Conclusions: We conclude that 56% of the operated patients with acute severe pancreatitis have a good outcome and they were discharged from hospital independently of the surgical procedure practiced.


REFERENCES

  1. Bassi C, Falconi M, Sartori N, et al. The role of surgery in the major early complications of severe acute pancreatitis. Eur J Gastroenterol Hepatol 2000;9:131-6.

  2. Mithöfer K, Mueller PR, Warshaw AL. Interventional and surgical treatment of pancreatic abscess. World J Surg 2001;21:162-8.

  3. Baron TH, Morgan DE. The diagnosis and management of fluid collections associated with pancreatitis. Am J Med 2000;102:555-63.

  4. Tsiotos GG, Luque-de Leon E, Soreide JA, Sarr MG. Long-term outcome of necrotizing pancreatitis treated by necrosectomy. Pancreas 2000;13:459.

  5. Widdison AL, Karanjia ND. Pancreatic infection complicating acute pancreatitis. Br J Surg 2001;80:148-54.

  6. Beckinghan IJ, Bornman PC. ABC of diseases of liver, pancreas and biliary system: Acute pancreatitis. BMJ 2001;322:595-8.

  7. Acosta JM, Katkhouda N, Pebian K, Groshen S, et al. Early ductal decompression versus conservative management for gallstone pancreatitis with ampullary obstruction. A prospective randomized trial. Ann Surg 2006;243:33-40.

  8. De Waele JJ, Hoste E, Stijn I, Decruyenaere J, Colardyn F. Intra-abdominal hypertension in patients with severe acute pancreatitis. Crit Care 2005;9:R452-R457.

  9. Hochman D, Louie B, Bailey R. Determination of patient quality of liar following severe acute pancreatitis. Can J Surg 2005;42:101-6.

  10. Balthazar EJ. Acute pancreatitis: Assessment of severity with clinical and CT evaluation. Radiology 2002;223:603-15.

  11. De Waele JJ, Hoste E, Stijn I, Hesse U, et al. Perioperative factors determine outcome alter surgery for severe acute pancreatitis. Crit Care 2004;8:R504-R511

  12. Mier J, Luque de León E, Castillo A, Robledo F, Blanco R. Early versus late necrosectomy in severe necrotizing pancreatitis. Am J Surg 1997;173:71-75.




2020     |     www.medigraphic.com