The Improvement of the Patients With Acute Destructive Panctreatitis Surgical Treatment

Vladimir M Demidov, PhD DSci Medicine, Sergei M Demidov, PhD Medicine. Odessa National Medical University, Ukraine


The number of the patients with the acute pancreatic gland parenchyma inflammation constantly increases due to the different environmental, feeding and other related pathological processes. Despite the intensive conservative and operative treatment in the 40-70% of the acute pancreatitis (AP) patients received destructive manifestation that makes more complex and difficult the forthcoming curing efforts.
The fundamental physiological and pathological disciplines stated that pancreatic parenchyma can’t absorb the pharmacological compounds during the first 3-5 days of the inflammation. Correspondently, in our daily practice we use the following approach that intensive pharmacological treatment we started from the 5th day after the disease onset while administering drugs with pacnreatoprotective functions through the catheter inserted into bursa omentalis.
28 patients with acute destructive pancreatitis were treated in the surgical department of the Odessa Municipal Hospital N10 during the last 3 years. The treatment was aimed to pancreatic gland edema diminishing, extrahepatic bile tracts decompression, usual desintoxicative and pancreatoprotective compounds administration etc. Abdominal cavity laparoscopic drainage was performed to 23 patients. Ten patients were treated traditionally with the very first days of the input to the department. 13 patients constituted the group of the patients to whom we gave the Sandostatin (Novartis Pharma Stein AG, Switzerland) and Deltaran (Russia).
Traditional AP treatment resulted in the certain improvement of the disease manifestation. Besides, the patients with the additional intrabursal Sandostatin and Deltaran administration started after the 5th day of the disease onset showed more progressive clinical condition improvement. There were no cases of the pancreonecrosis development in this group of patients (2 patients out of 10 with the traditional AP treatment had pancreonecrosis). We didn’t observe any cases of complication among the 13 patients treated with Sandostatin and Deltaran (2 complications were in 10 patients with the traditional AP treatment). The average time of patients treated traditionally days-in the hospital equal to 9-14 days. The average time of patients who received Sandostatin and Deltaran days-in the hospital was 4-7 days shorter comparing with the same index in the traditionally treated patients.
Hence, we can conclude that intrabursal pharmacons with the potent pancreatoprotective properties administration in patients with destructive AP has some important advantages. There are less cases of disease progression, less cases of complications and the quicker improvement of the patient. The very important idea we worked with is that intrabursal drugs administration we stared 5 days later waiting for the termination of the initial stage of pancreatic gland inflammation.

Session Number: Poster – Poster Presentations
Program Number: P379
View Poster

« Return to SAGES 2012 abstract archive