Kasian V.V., Cherkun O.Yu., Tkachenko O.A., Sheiko V.D.

EFFICIENCY OF DRAINAGE OF ASCIT-PERITONITIS IN DIFFERENT DIFFICULTY OF ACUTE PANCREATITIS

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About the author:	Kasian V.V., Cherkun O.Yu., Tkachenko O.A., Sheiko V.D.
Heading	CLINICAL MEDICINE
Type of article	Scentific article
Annotation	The global incidence of acute pancreatitis ranges from 5 to 30 cases per 100,000 people per year and continues to grow in recent years. A fifth of patients are diagnosed with a severe form of acute pancreatitis with a mortality rate of up to 30%. Publications and randomized clinical trials show conflicting data on the effectiveness of abdominal drainage in acute pancreatitis complicated by ascites-peritonitis. The aim of the study was to analyze the effectiveness of drainage interventions in acute pancreatitis complicated by ascites-peritonitis depending on the initial severity of the patient's condition. We analyzed the results of a comprehensive examination and treatment of 166 patients with acute pancreatitis complicated by enzymatic ascites peritonitis. In the subgroups with the severity of the condition at the time of hospitalization, defined on the APACHE II scale of 5 or more points, a statistically significantly lower number of unsatisfactory results (p <0.05) was observed 72 hours after the start of treatment in drained patients compared with patients whose treatment included only complex conservative therapy. In the subgroups with the severity of the condition at the time of hospitalization, the APACHE II score of less than 5 points, active surgical tactics did not have a statistically significant effect on the incidence of unsatisfactory treatment results and there was no significant difference between the condition of the drained and non-drained patients. These results confirm the absence of the influence of routine abdominal drainage for all patients with acute necrotic pancreatitis. However, patients with an APACHE II score of 5 and above are the category of patients who will be most justified in early drainage of ascites-peritonitis.
Tags	ascites-peritonitis, acute pancreatitis, abdominal drainage, severity of condition
Bibliography	Chen Y, Zak Y, Hernandez-Boussard T, Park W, Visser BC. The epidemiology of idiopathic acute pancreatitis, analysis of the nationwide inpatient sample from 1998 to 2007. Pancreas. 2013; 42(1): 1–5. Kasian VV, Cherkun OJu, Sytnik DA, Sheiko VD. Surgical policy upon tretament of acute pancreatitis complicated by ascites-peritonitis. Zaporozhye medical journal. 2019; 21 (4): 522-527. doi: 10.0.57.147/2310-1210.2019.4.173353 Nesvaderani M, Eslick GD, Cox MR. Acute pancreatitis: Update on management. Med J Aust. 2015; 202(8):420–3. Noel P, Patel K, Durgampudi C, Trivedi RN, De Oliveira C, Crowell MD, et al. Peripancreatic fat necrosis worsens acute pancreatitis independent of pancreatic necrosis via unsaturated fatty acids increased in human pancreatic necrosis collections. Gut. 2016; 65(1):100–11. Tee YS, Fang HY, Kuo IM, Lin YS, Huang SF, Yu MC. Serial evaluation of the SOFA score is reliable for predicting mortality in acute severe pancreatitis. Med (United States). 2018; 97(7):1–6. Yokoe M, Takada T, Mayumi T, et al. Japanese guidelines for the management of acute pancreatitis: japanese guidelines 2015. Journal of Hepato-Biliary-Pancreatic Sciences. 2015; 22(6):405–432. doi: 10.1002/jhbp. Zhu L, Lu J, Yang J, et al. Early-phase peritoneal drainage and lavage in a rat model of severe acute pancreatitis. Surgery Today. 2016; 46(3): 371–378. doi: 10.1007/s00595-015-1172-9.
Publication of the article	«World of Medicine and Biology» №1(71), 2020 year, 069-072 pages, index UDK 616.381-002.1-06:616.37-002.1:617-089
DOI	10.26724/2079-8334-2020-1-71-69-72