Jurnalul de Chirurgie
 Jurnalul de chirurgie
Aparitie trimestriala in a doua luna a trimestrului
Published quarterly in the second month of the quarter
ISSN: 1584 - 9341 Vol.10 Nr.3 - Iulie-Septembrie 2014 | sâmbătă, 23 martie 2019
ISSN: 1584 - 9341 Vol.10 No.3 - July-September 2014
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WHAT WE OPERATE? WHEN WE OPERATE? AND HOW WE OPERATE ACUTE PANCREATITIS?
V. Panescu, Ioana Bordânca, C. Popa, Valentina Pop-Began, D. Pop-Began

Surgery Clinic, Emergency Clinic Hospital „Bagdasar-Arseni” Bucuresti
Jurnalul de chirurgie 2006; 2 (4):378-391
Full text: Format PDF (Romanian)

Abstract:

In a prospective study of 186 patients with acute pancreatitis (A.P.), the clinical form is a risk factor in the evolution and prognostic of the disease (p < 0,001), the procentage of deaths in a severe acute pancreatitis (S.A.P.) (n = 79; 42,47%) is much higher (n = 33; 41,77%) than in the edematous form (n = 5; 4,67%).

The age over 55 years (n = 85; 45,70%) was identified as a negative prognostic factor beside sex (M = 113; 60,75%) for the severe form. The severe form is in the majority of cases the outcome of biliary pathology (n = 105; 56,45% ).

The lithiasis of common biliary duct has a positive predictive value representing 70,5% in the determination of deaths. Between non-biliary ethiologies a major role play the ethanol (n = 49; 60,49%). Among symptoms, abdominal pain, nausea/vomiting and fever occur more often in S.A.P. and represent risk factors in evolution and prognostic of morbidity of A.P. (p < 0,001).

The risk factors that increase the gravity of necrotic form and which had the highest amounts are represented by: for sensibility: urea > 100 mg%, fever: 84,81%; for specificity: the extension of pancreatic necrosis = 100% and leucocytosis > 16000/mm3 = 96,26%; for the positive predictive value: urea > 100mg% = 83,5%; for the negative predictive value: nausea/vomiting = 84,7%; and for accuracy: the extension of pancreatic necrosis = 85,4%.

The risk factors involved in the lethal outcomes had: the sensibility: glicemy > 200mg% = 87,8%; for specificity and positive predictive value: the extension of necrosis = 100%; for accuracy: glicemy > 200mg% = 87,8% and extension of necrosis: 84,2%.

The severe form of A.P. is associated with a higher incidence of local complications (necrosis extension: n = 52; 65,82%; intraperitoneal inflammatory exudate: n = 42%; 53,16%) and systemic complications: renal insufficiency (n = 61), cardiovascular insufficiency (n = 58), respiratory insufficiency (n = 41), encephalopathy (n = 32), identified at all the deaths (n = 33).

KEYWORDS: SEVERE ACUTE PANCREATITIS, PREDICTION OF RISK FACTORS, NECRECTOMY, PERITONEAL LAVAGE

Paper presented to the 4-th International Conference of Surgery, Iasi, October 19-22, 2006

 



: Creative Commons License
Jurnalul de chirurgie [Journal of Surgery] by Editorial Board, Department of Surgery University of Medicine and Pharmacy Iasi, E. Tarcoveanu, R. Moldovanu is licensed under a Creative Commons Attribution-NonCommercial-NoDerivs 3.0 Unported License.
Based on a work at www.jurnaluldechirurgie.ro.