Predictors for clinically relevant pancreatic fistulas after surgical treatment infected pancreatic necrosis.

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Abstract


Aim to analyze the risk factors for clinically relevant pancreatic fistulas after surgical treatment of infected pancreatic necrosis. Methods and materials. We conducted a retrospective analysis of 44 successive cases of surgical treatment infected pancreatic necrosis. Risk factors for development clinically relevant pancreatic fistulas were investigated by Spearman’s correlation coefficient.

Results. In the follow-up the reoperations were performed due to pancreatic fistulas in 11,36% and to pseudocysts – in 9%. Conversely, a significant moderate correlation was observed between clinically relevant pancreatic fistulas and the following factors: pancreatic necrosis in the neck (r=0,31, p=0,00), its depth 50% and more (r=0,46, p=0,00), volume of drainage fluid output (r=0,55, p=0,00) and drain amylase level (r=0,53, p=0,00). Conclusion. Pancreatic necrosis in the neck, its depth 50% and more, volume of drainage fluid output more than 150 ml (r=0,55, p=0,00) and drain amylase level more 1000 U/L were risk factors for pancreatic fistulas after surgical treatment of infected pancreatic necrosis


About the authors

Luidmila Kotelnikova

Пермский государственный медицинский университет им. академика Е.А. Вагнера

Author for correspondence.
Email: splaksin@mail.ru

Russian Federation

доктор медицинских наук, профессор кафедры хирургии ФДПО

Pavel Kudryavsev

Email: hirfpk159@gmail.ru

References

  1. Дюжева Т.Г., Шефер А.В., Семененко И.А.,Пинский А.Б., Конторщикова Е.С., Джус Е.В., Платонова Л.В., Гальперин Э.И. Наружный панкреатический свищ – отражение многих проблем лечения хронического панкреатита . Материалы пленума правления ассоциации хирургов-гепатологов России и стран СНГ. Ижевск 2012; 23-25.
  2. Калиев А.А. Анализ летальных исходов больных деструктивной формой острого панкреатита. Современные проблемы науки и образования. 2013; 5:
  3. Кригер А.Г., Ахтанин Е.А., Земсков В.М., Горин Д.С., Кармазановский Г.Г., Ветшева Н.Н., Нерестюк Я.И., Калинин Д.В., Глотов А.В. Факторы риска и профилактика послеоперационного панкреатита при резекционных вмешательствах на поджелудочной железе. Хирургия. Журнал им.Н.И. Пирогова. 2016; 8: 25-32
  4. Коробка В.Л., Шаповалов А.М., Данильчук О.Я., Громыко Р.Е., Коробка Р.В. Варианты хирургического лечения больных хроническим панкреатитом, осложненным панкреатическим свищем . Вестник экспериментальной и клинической хирургии. 2012; 2:423-429.
  5. Рахимов Р.Р. Комплексный подход к диагностике и лечению инфицированного панкреонекроза. Пермский медицинский журнал. 2016; 6:36-41.
  6. Beger H.G., Rau B.M. Severe acute pancreatitis: Clinical course and management. World J Gastroenterol. 2007; 13(38): 5043-5051
  7. Bassi C., Butturini G., Falconi M., Salvia R., Frigerio I., Pederzoli P. Outcome of open necrosectomy in acute pancreatitis. Pancreatology. 2003; 3:128-132.
  8. Calu V., Dutu M., Parvuletu R., Miron A/ Persistent pancreatic fistula after necrosectomy for severe pancreatitis. Chirurgia. 2012: 107(6): 796-801.
  9. Chen J.Y., Feng J., Wang X.Q., Cai S.W., Dong J.H., Chen Y.L. Risk scoring system and predictor for clinically relevant pancrearic fistula after pancreaticoduodenectomy. World J Surg. 2015; 21:5926-5933.
  10. Doctor N., Philip S, Gandhi V., Hussain M., Barreto S.G. Analysis of the delayed approach to the management of infected pancreatic necrosis. World J Gastroenterol. 2011; 17 (3): 366-371.
  11. Kannegantia K., Srikakarlapudi S., B. Acharya Successful management of pancreatic ascites with both conservative management and pancreatic duct stenting. Gastroenterology Research. 2009; 2(4): 245-247.
  12. Kozarek R.A., Brandabur J.J., Ball T.J. Endoscopic and interventional therapy of chronic pancreatitis. Gastrointest Endosc. 2005; 61950:568-575.
  13. Le Bian A., Fuks D., Chopinet S., Gaujoux S., Cesaretti M., Belgaumkar A.P., Smadja C., Gayet B. Consequences of metabolic syndrome on postoperative outcomes after pancreaticoduodenectomy. World J Gastroenterol. 2017; 23 (17): 3142-3149.
  14. Sandrasegaran K., Tann M., Jennings S.G., Maglinte DD., Peter SD., Sherman S. Disconnection of the pancreatic duct: an important but overlooked complication of severe acute pancreatitis . Radiographics. 2007; 17(5): 1389-1400.
  15. Sikora S.S., Khare R., G. Srikanth, Kumar A., Saxena R., Kapoor V.K.. External pancreatic fistula as a sequel to management of acute severe necrotizing pancreatitis. Dig Surgery. 2005; 22(6): 446-451. 19.
  16. Wen Z., Guo Y., Xu B.,Xiao K., Peng T., Peng M. Developing Risk Prediction Models for Postoperative Pancreatic Fistula: a systematic review of methodology and reporting . Indian J Surg. 2016; 78 (2): P.136-143

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