The contemporary approach to treatment of acute pancreatitis (AP) is far from satisfactory. This resulted in the increased number of AP patients as well as increased number of cases that developed complications. Our idea is not an original one since we strictly followed the guidelines of the World and European Pancreatic Societies that recommend obtaining as conservative as possible approach for the AP treatment during the stage of aseptic inflammation. We performed the series of retrospective clinical observations aimed to compare the efficacy of the previous immediate surgical interventions in the case of AP with the tactics of accurate adequate conservative treatment.
Clinical observations were performed during the last 5 years. Surgical treatment was used in the case of the patients general condition worsening. For the new methodology of the non operative treatment we used the intensive medical therapy including antibiotics, antioxidants, antiinflammatory and antinociceptive drugs. Inhibition of pancreatic secretion was also applied. Briefly, the non operative treatment of AP was complex and required day-by-day and week-by-week re-evaluation of the patients’ condition with the treatment tailored to the changes that rapidly occurred in critical patients.
From 99 patients operated during the very first days in the hospital, 13 patients improved general condition, 61 patients demonstrated stable clinical manifestation with the mild prolonged shift to the improvement, 19 patients needed repeated operations and 6 patients died.
In the group of 120 patients to whom we applied the intensive conservative treatment, 75 patients recovered soon. Stable clinical manifestation was observed in 33 patients, 9 underwent traditional surgical interventions and 3 patients died.
These data are in strong correspondence with the leading opinion that pancreatic gland sterile aseptic inflammation should not be operated but treated conservatively. Our results are significantly better compared with the results of the AP traditional treatment. This might have important medical and social implications, since the patients with AP often represent the working category of people and it is of crucial importance to restore their working abilities in terms of their quality of life and economic contribution to the society.
Program Number: P395