Herald of Pancreatic Club最新文献

{"title":"Optimization of the complex treatment of chronic pancreatitis in elderly patients using systemic enzyme therapy","authors":"N. O. Shevchenko, L. Babinets","doi":"10.33149/vkp.2023.02.02","DOIUrl":"https://doi.org/10.33149/vkp.2023.02.02","url":null,"abstract":"In the last few years, the number of young people with pancreatic pathology has increased.  However, exacerbation of chronic pancreatitis (CP) in “favorable conditions” occurs at any age, leading to extremely unfavorable consequences. The aim is to study clinical and etiological factors of CP in elderly patients and optimize the complex treatment of this category of patients by including a systemic enzyme therapy agent. Materials and methods. The study included 98 CP patients, with a mean age of 71.3±1.4 years, who were randomized into two groups. All patients received the standard conventional treatment complex (CTC): pantoprazole 40 mg on an empty stomach on demand; prolonged enzyme replacement therapy with pure pancreatin at an adequate dose with each meal; prokinetics and/or antispasmodics as needed for 6 weeks. The study group was randomized into two groups: group I (CTC) — 20 patients got only CTC; group II (CTC+W) — 78 patients received Wobenzym in addition to CTC, 5 tablets three times per day. Results and discussion. It has been proven that CP in elderly patients occurs against the background of mixed etiopathogenetic factors: ischemic (87.7%), gastroduodenal (84.7%), and dyslipid (70.4%). Clinically, asthenic and dyspeptic syndromes predominate (92.8% and 77.5%, respectively). According to the anthropometric examination, body weight deficiency is observed in 64.3% of the examined, with endocrine pancreatic insufficiency in 29.6% in terms of fasting glucose and exocrine pancreatic insufficiency in 70.4% in terms of FαE. The use of CTC contributed to the reduction of dyspeptic and painful abdominal syndromes (p˂0.05), a decrease in body weight deficit by 4.3% in terms of body mass index, and a tendency to normalize pancreatic function. Conclusions. The addition of CTC with Wobenzym resulted in a decrease in the clinical manifestations of the disease (p<0.03–p<0.05), an improvement in carbohydrate imbalance in terms of postprandial glycemia (p<0.05), and a trend towards a decrease in the level of glycated hemoglobin by an average of 0.2%. The administration of Wobenzym in the complex treatment of CP in elderly patients contributed to an increase in the level of FαE by 42.6% compared to this index before treatment (p<0.001) and a decrease in nutrient deficiency due to the elevated body mass index of this category of patients by 7.0%.","PeriodicalId":378182,"journal":{"name":"Herald of Pancreatic Club","volume":"9 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139360599","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of endothelial dysfunction, microcirculatory disorders, and hypoxia as mechanisms for the formation of lung lesions","authors":"T. Hristich, D. Hontsariuk","doi":"10.33149/vkp.2023.03.02","DOIUrl":"https://doi.org/10.33149/vkp.2023.03.02","url":null,"abstract":"In a review article, the authors consider the significance of endothelial dysfunction, microcirculation disorders, and hypoxia in the development of lung diseases and in the comorbid course of a number of other diseases of the internal organs. The role of endotheliocytes in the systemic response to inflammatory processes in the case of damage to the bronchopulmonary system is considered. Endothelial cells counteract pathogens in the blood and send signals warning of infection, invasion, or injury. The importance of the anticoagulant and antithrombotic properties of the endothelium (including the pulmonary one), which contribute to the fight against thrombosis, is emphasized. It is indicated that endothelial cells have an endogenous mechanism to combat platelet activation. This function depends on the surface expression of ecto-ATPase, CD39, and the release of nitric oxide and prostacyclin. Attention is paid to the importance of activation of the renin-angiotensin-aldosterone system both through angiotensin-II and through aldosterone. The authors stressed the importance of endothelial dysfunction as an imbalance between the factors of relaxation and constriction, coagulation, and fibrinolysis, which provide hemostasis of the main vital regulatory systems, and the stage of disease compensation (via the participation of nitric oxide). Microcirculation disorders and hypoxia are considered phenomena that are compatible in pathogenesis not only with pulmonary diseases but also as common comorbid syndromes with other diseases of the internal organs. This is explained by the fact that the common links are chronic oxidative stress, the reaction of the immune system to damage, the formation of a low-grade chronic systemic inflammation syndrome, a violation of the microcirculation process, and an increase in hypoxic and ischemic processes. The importance of knowledge about the mechanisms of development of endothelial dysfunction, microcirculation disorders, and hypoxia for therapeutic and rehabilitation tactics is emphasized.","PeriodicalId":378182,"journal":{"name":"Herald of Pancreatic Club","volume":"110 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139360391","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Miracle drugs and drug-induced liver injury: possible relationships and parallels (clinical observation of severe drug-induced damage to the liver, pancreas and kidneys)","authors":"N. Gubergrits, T. L. Mozhyna, N. Byelyayeva","doi":"10.33149/vkp.2023.03.08","DOIUrl":"https://doi.org/10.33149/vkp.2023.03.08","url":null,"abstract":"The article discusses the provisions for identifying guidelines with the identification of the association for the study of the liver (European Association for the Study of the Liver, EASL) and the American Association for the Study of Serious Liver Diseases (American Association for the Study of Liver Diseases, AASLD) for the immediate detection of drug-induced disease (DILI). Data on the etiology, exclusions, and isolation of DILI, methods of diagnosis, examination, and management of patients with DILI, both with the use of pharmacological therapy and liver transplantation, are presented. A clinical case of multiple lesions of the liver, kidneys, and pancreas is presented against the background of long-term use of a combined drug containing acetaminophen and metamizole. The calculation of the RUCAM score confirmed that acetaminophen could be the etiological factor in chronic DILI in this case. According to the EASL recommendations, the type of DILI was determined in AASLD — a cholestatic type of lesion was stated. The presence of concomitant kidney damage in the form of chronic kidney disease, drug-induced interstitial nephritis, hepatorenal syndrome, and uremia had a great influence on the possibilities of pharmacological correction of DILI. Presumably, the long-term toxic effects of acetaminophen led to the development of pancreatic steatosis, followed by degeneration into non-alcoholic fatty pancreatic disease with the development of moderate exocrine organ insufficiency. Recommended drugs that help resolve intrahepatic cholestasis (Heptral®, Bicyclol), pancreatic (Creon®), and renal failure, the issue of prescribing corticosteroids is being resolved. A feature of this clinical case is the development of subclinical drug-induced primary biliary cholangitis (AMA-M2 were detected).","PeriodicalId":378182,"journal":{"name":"Herald of Pancreatic Club","volume":"112 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139360526","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Features of nutrition in exocrine pancreatic insufficiency and metabolic syndrome","authors":"D. Hontsariuk, M. A. Hrushеlevskii","doi":"10.33149/vkp.2023.03.04","DOIUrl":"https://doi.org/10.33149/vkp.2023.03.04","url":null,"abstract":"The review presents literature data on the importance of nutritional goals, which include ensuring sufficient intake of macro- and micronutrients, reducing indigestion, the degree of malabsorption, and other risk factors in order to prevent or treat malnutrition associated with exocrine pancreatic insufficiency. Nutritional status and nutritional interventions depend on this. Attention is drawn to the indication of different nutritional options depending on the severity of the course of exocrine insufficiency and the presence of diabetes (10–15% need oral nutritional supplements, 5% — enteral nutrition through a tube, and about 1% — parenteral nutrition). The European Society for Clinical Nutrition and Metabolism (ESPEN) Guidelines for Nutritional Screening are presented. The question of the impact of chronic pancreatitis and exocrine pancreatic insufficiency on digestion with the development of maldigestion and malabsorption and the importance of these factors for the quality of life is discussed. The author reviewed in detail the metabolism of carbohydrates, proteins, and fats in enzyme pancreatic insufficiency and the importance of this knowledge in providing nutritional recommendations. The digestion of lipids in the lumen of the small intestine depends on pancreatic lipase and cofactors such as colipase and bile acids. Lipases of the stomach and salivary glands play a minor role in the digestion of triglycerides and cannot compensate for the insufficient fat digestion. There are no enzyme systems for digesting triglycerides in the brush border membrane. Therefore, lipid digestion is reduced due to insufficient secretion of lipase and a decrease in the concentration of bile acids in the lumen. Attention is paid to research methods that determine the state of fat, lean mass, muscle state, bone health, and resting energy expenditure, provide an opportunity to conduct a detailed assessment of current and usual food consumption, which promotes successful treatment.","PeriodicalId":378182,"journal":{"name":"Herald of Pancreatic Club","volume":"20 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139360568","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Physicochemical properties of blood and urine in patients with alcohol-induced chronic pancreatitis against the background of obesity","authors":"N. Gubergrits, N. Byelyayeva, S. S. Severin, E. O. Severina","doi":"10.33149/vkp.2023.03.07","DOIUrl":"https://doi.org/10.33149/vkp.2023.03.07","url":null,"abstract":"In this article, the authors present the results of their studies of the physicochemical properties of blood and urine in patients with chronic alcohol-induced pancreatitis (CAP) combined with obesity. 110 patients with CAP in the acute stage against the background of obesity were examined. The ages of the examined patients ranged from 23 to 60. There were 77 (70.0%) men and 33 (30.0%) women among the patients. We also examined 30 almost healthy people aged 20 to 60 (the control group). There are significant changes in the physicochemical properties of blood and urine in patients with CAP against the background of obesity. Indices of interfacial tensiometry and rheometry of these biological fluids correlate with other clinical, laboratory, and instrumental data in patients with CAP combined with obesity. This allows us to recommend the assessment of dynamic surface tension and rheometric indices of blood and urine for screening and an integral assessment of the functional state of the pancreas in comorbidity. In addition, it is reasonable to use the results of interfacial tensiometry and rheometry for screening the metabolic syndrome in patients with CAP against the background of obesity. In the metabolic syndrome, there is a significant increase in the surface tension 3 of the blood; in the absence of this syndrome, on the contrary, the surface tension 3 of the blood is significantly reduced. In patients with biliary sludge and cholelithiasis, the blood viscoelasticity index (E) was significantly lower (23.18±1.07 mN/m), while without concomitant diseases of the biliary tract, the blood E was equal to 27.84±1.08 mN/m (p<0.05). Both with and without changes in the biliary system, blood E in patients with CAP against the background of obesity was significantly lower than in the control group. The prospects of research are to study the dynamics of tensiometry and rheometry of biological fluids in CAP combined with obesity under the influence of treatment in order to study the possibility of using these indices in the integrated assessment of the effectiveness of therapy.","PeriodicalId":378182,"journal":{"name":"Herald of Pancreatic Club","volume":"193 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139360286","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relief of symptoms of gastric and intestinal dyspepsia in chronic pancreatitis","authors":"N. Gubergrits, N. Byelyayeva, O. Suprun","doi":"10.33149/vkp.2023.03.06","DOIUrl":"https://doi.org/10.33149/vkp.2023.03.06","url":null,"abstract":"The authors examined 62 patients with chronic pancreatitis (CP). The diagnosis was confirmed by the typical clinical picture of CP, the phenomenon of “deviation” of enzymes in the blood (monitored by the levels of α-amylase, pancreatic blood isoamylase, and blood lipase), and typical sonographic changes in the pancreas. There were 34 (54.8%) women and 28 (45.2%) men among the patients. Their ages ranged from 27 to 63. The control group had 30 almost healthy people. The severity of subjective manifestations (complaints) was assessed before and after treatment by an indicator of moderate severity using a semi-quantitative scale. To assess the gastric evacuation rate, a 13C-octane breath test was performed before and after treatment. To diagnose the small intestinal bacterial overgrowth syndrome, a hydrogen breath test was performed before and after treatment. The patients were divided into two groups. The main group included 32 (51.6%) patients, and the comparison group included 30 (48.4%) patients. Patients of the main group were administered conventional CP treatment (antisecretory drugs, infusion therapy, if necessary, antibiotics, analgesics, and Creon® as an enzyme preparation), as well as domperidone 10 mg 3 times a day 15–20 min before meals, a preparation containing Bacillus clausii spores, one vial 3 times a day between meals (at regular intervals) for 3 weeks. Patients in the comparison group received only conventional treatment. The inclusion of domperidone and a preparation containing Bacillus clausii spores in the therapeutic complex for CP patients (provided that Creon® was used as an enzyme preparation in the basic therapy) helps reduce the severity of the clinical manifestations of the disease. The obvious advantages of this therapeutic complex relate to the relief of pain and dyspeptic syndromes, especially the elimination of symptoms of intestinal dyspepsia. Under the influence of treatment with domperidone, a drug that contains Bacillus clausii spores, and Creon®, the exocrine pancreatic function is optimized much better than when only conventional therapy is used. This is likely because Creon® is more effective in duodenal decontamination.  Domperidone significantly accelerates initially delayed gastric evacuation in patients with CP. The addition of a preparation containing Bacillus clausii spores to the conventional treatment effectively eliminates the bacterial overgrowth syndrome in exocrine pancreatic insufficiency. The prospects of research are to study the dynamics of the sonographic manifestations of CP under the impact of treatment.","PeriodicalId":378182,"journal":{"name":"Herald of Pancreatic Club","volume":"158 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139360370","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gut microbiota and pancreatic diseases: a microbiome-associated approach in the treatment of chronic pancreatitis","authors":"N. Gubergrits, T. L. Mozhyna, N. Byelyayeva","doi":"10.33149/vkp.2023.03.03","DOIUrl":"https://doi.org/10.33149/vkp.2023.03.03","url":null,"abstract":"Intestinal microbiota is a factor that determines human health, maintains body homeostasis, and influences the development of pancreatic diseases (acute pancreatitis, chronic pancreatitis (CP), and cancer). Butyrate, acetate, propionate, and key short-chain fatty acids, which are synthesized by probiotic bacteria, have a significant effect on the functional pancreatic activity: anti-inflammatory effect, modulation of pancreatic β-cell function, regulation of pancreatic cell mass, and strengthening of the intestinal barrier function. It has been proven that the course of CP is associated with intestinal dysbiosis, bacterial overgrowth syndrome, a decrease in the levels of Firmicutes and Actinobacteria, and an increase in the levels of Proteobacteria phylum, Eubacterium rectale, Coprococcus, Sutterella, and Eubacterium ruminantium. Their predominance is related to exocrine pancreatic insufficiency, while Pseudomonas, Fusobacterium, and Ruminococcus gnavus are more common in CP patients without exocrine pancreatic insufficiency. Activation of pancreatic fibrogenesis is associated with an increase in Streptomyces, Turicibacter, Methylobacterium, Enterococcus, and Candidatus Paenicardiniummore. The mechanism of action of probiotics in pancreatic diseases is associated with improved functioning of the intestinal barrier, decreased BOS and the inflammatory process, and inhibition of the signaling pathway of oncogenesis. The microbiome-associated approach to treating CP is based on the additional administration of probiotics. The multicomponent probiotic Laktiale Multi can be the drug of choice.","PeriodicalId":378182,"journal":{"name":"Herald of Pancreatic Club","volume":"3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139360272","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Modern capabilities of digital pancreatology","authors":"A. A. Litvin","doi":"10.33149/vkp.2023.03.01","DOIUrl":"https://doi.org/10.33149/vkp.2023.03.01","url":null,"abstract":"Personalized medicine requires the integration and analysis of vast amounts of patient data in order to provide a personalized approach. Digital pancreatology and Pancreomics facilitate personalized recommendations in the diagnosis and treatment of pancreatic diseases by analyzing data using machine learning methods to exploit the potential of this data in a similar way to Pathomics, Radiomics, and Genomics. The aim of this article is to present a brief overview of the modern capabilities of digital medicine for the diagnosis and treatment of various pancreatic diseases. The studies included in the review demonstrate the promising results of machine learning technologies that can both facilitate clinical prediction and decision-making and be used to interpret clinical laboratory, radiological, and endoscopic images in pancreatology and medicine in general. Digital pancreatology and Pancreomics may be promising concepts for the analysis and prediction of the course of pancreatic diseases in the contemporary digital era.","PeriodicalId":378182,"journal":{"name":"Herald of Pancreatic Club","volume":"11 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139360585","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"News of European Pancreatology (based on the materials of the 52nd meeting of the European Pancreatic Club)","authors":"N. Gubergrits, N. Byelyayeva, G. Lukashevich, L. Yaroshenko, A. Klochkov, A. Yuryeva, K. Borodiy","doi":"10.33149/VKP.2020.04.01","DOIUrl":"https://doi.org/10.33149/VKP.2020.04.01","url":null,"abstract":"The 52nd meeting of the European Pancreatic Club was organized and conducted online in Paris on July 2–3, 2020. It is the first time the Congress took place online, with about a thousand of pancreatologists having participated in it. The high scientific, organizational and technical level of the congress should be noted. \u0000This review presents the most interesting research results in the following sections: anatomy of the pancreas, acute early chronic, autoimmune pancreatitis, cancer and other malignant pancreatic diseases, functional pancreatic insufficiency, enzyme replacement therapy, pancreatic steatosis, microbiota in pancreatic pathology. \u0000Dugic et al. (Sweden) conducted a systematic review “The effect of anatomical variants of the Wirsung’s duct on exocrine function and risk of pancreatic pathology”. Studies of the MEDLINE database from 1960 to 2019 were analyzed; data of 3234 patients were included. A classification of anatomical variants of the pancreatic duct system was compiled. \u0000A lecture by T. B. Gardner (Great Britain) on pancreatic steatosis drew great attention. The problem of pancreatic steatosis is surrounded by a number of unresolved issues; the terminology of pancreatic steatosis itself is unclear. Under conditions of oxidative stress, cytokines released from adipocytes trigger the local inflammation and dysfunction of the affected pancreatic cells. The pathogenesis of pancreatic steatosis requires further studies. \u0000The symposium on exocrine pancreatic insufficiency in pancreatic cancer played the central role in the congress. Professor E. Dominguez-Munoz (Spain) gave a lecture within the framework of the symposium. 80% of patients with pancreatic cancer have sarcopenia and/or cachexia. Sarcopenia and cachexia in pancreatic adenocarcinoma are the most obviousamong all tumor localizations. The pathogenesis of cachexia and sarcopenia in pancreatic cancer was analyzed in detail; the necessity of enzyme replacement therapy with Creon was substantiated. Particular attention was paid to the pathogenesis of pancreatic insufficiency after surgical treatment (pancreatic resections, pancreatectomy); the features of replacement therapy were highlighted. \u0000The meeting of the European Pancreatic Club, as usual, was informative and interesting","PeriodicalId":378182,"journal":{"name":"Herald of Pancreatic Club","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127891433","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bacterial overgrowth syndrome of upper parts of gastrointestinal tract in acute necrotizing pancreatitis","authors":"O. Rotar, I. Khomiak, V. Polioviy, V. Rotar","doi":"10.33149/VKP.2020.04.05","DOIUrl":"https://doi.org/10.33149/VKP.2020.04.05","url":null,"abstract":"Aim: to study the changes in the microflora of the upper part of digestive tract during acute necrotizing pancreatitis. \u0000Material and methods. Acute necrotizing pancreatitis was induced in 42 white rats; changes in the mucous microflora of the upper part of digestive tract were studied. Bacteriological examination of the contents of the proximal small intestine was performed in 42 patients with acute necrotic pancreatitis during gastrofibroscopy. \u0000Results and discussion. Induction of acute necrotic pancreatitis was accompanied by impaired colonization resistance of the intestinal mucosa due to the elimination of bifidobacteria and lactobacilli: the frequency of their growth from the mucosa decreased threefold (p<0.01), and the population level, respectively, by 25% (p<0.05) and by 36% (p<0.02). The mucosa was actively colonized by gram-negative pathogenic and conditionally pathogenic enterobacteria at high population level (3.07‒5.39 lg CFU/g), which allowed this microflora to overcome the damaged intestinal barrier and translocate. Pathogenic Escherichia spp. and Proteus spp. were cultivated from the mesenteric lymph nodes in 24 hours; Enterobacteria spp. and Staphylococci spp. were isolated from portal blood, pancreatic tissue, and peritoneal cavity 48 hours after induction of acute pancreatitis. Eight strains of gram-negative microorganisms were identified in small intestine in 69% of patients before surgery. Similar microflora was cultivated from pathological foci in 57.4% of patients after surgery. \u0000Conclusion. Severe deficiency of autochthonous anaerobic microflora occurred in the upper parts of the digestive tract in acute necrotizing pancreatitis, causing excessive colonization by pathogenic and conditionally pathogenic microorganisms and promoting bacterial translocation.","PeriodicalId":378182,"journal":{"name":"Herald of Pancreatic Club","volume":"307 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133075068","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}