Exocrine secretion oppression as game changing tool in acute pancreatitis surgical treatment

S. Podpryatov, O. Ivanko, S. S. Popdryatov, O. Levytska, V. Korchak
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Abstract

the aim of the work: to assess changes in tactic of surgical treatment of acute destructive pancreatitis (ADP) due to octreotide prescription in high dose 1 mg/day (OHD). Materials and Methods. OHD had been used as treatment of 6 patients with ADP. Within first two days of illness in such way were treated 4 patients (group1), in terms of two weeks after disease beginning OHD treatment had been applied to 2 patients (group2). All patients gave an informed consent to applied treatment. There were 2 women and 4 men in the age from 17 to 75 years. Gallstone disease combined with excessive eating lied ground to ADP outbreak in 2 patients, alcohol excessive consumption combined with overeating in 4. In our observations acute pancreatitis was diagnosed on integrated assessing results of clinical appearances, and results of laboratory and instrumental examining. OHD had been prescribed to every patient immediately after the diagnosis had been stated. Results and Discussion. All patients from group 1 became free from clinical signs of ADP two hours after OHD administering. Prolongation of the OHD use during next two days resulted in normalizing of general clinical state and amylase level. In one patient after two days of OHD treatment clinical signs didn’t normalized. There left some abdominal pain and substantial meteorism. Both patients from group 2 obtain stabilization of general clinical status with the clear expression a sign of a local abscess. By means of computed and magnetic tomography almost two local niduses in every patient had been localized and subsequently subjected it to healing through a mini-invasion approach. Both patients recovered. Conclusion. Thus, we can suggest that proposed method of OHD treatment cause stabilization of pancreatic parenchyma what may be the reason for observed immediate break of inflammation.  
外分泌抑制在急性胰腺炎手术治疗中的作用
目的:评价奥曲肽高剂量1mg /d (OHD)引起的急性破坏性胰腺炎(ADP)手术治疗策略的变化。材料与方法。OHD治疗ADP 6例。4例患者在发病前2天内采用上述方法治疗(第一组),2例患者在发病后2周内采用OHD治疗(第二组)。所有患者均对应用治疗给予知情同意。有2名女性和4名男性年龄在17到75岁之间。胆结石病合并暴饮暴食2例,饮酒过量合并暴饮暴食4例。在我们的观察中,急性胰腺炎的诊断是根据临床表现、实验室和仪器检查结果的综合评估结果。在确诊后,医生立即给每位患者开了OHD处方。结果和讨论。1组患者在给予OHD治疗2小时后均无ADP临床症状。在接下来的两天内延长OHD的使用导致一般临床状态和淀粉酶水平正常化。一名患者在接受OHD治疗两天后,临床症状没有恢复正常。留下了腹痛和严重的眩晕。2组患者总体临床状况稳定,有明显的局部脓肿征象。通过计算机和磁层析成像,每位患者几乎有两个局部病灶被定位,并随后通过小侵入方法进行治疗。两名患者都康复了。结论。因此,我们可以认为,所提出的OHD治疗方法导致胰腺实质稳定,这可能是观察到炎症立即破裂的原因。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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