I. Fedoriv, MD, V. Myesoyedova, MD. Dpt. of Surgery. Ivano-Frankivsk national medical university. Ukraine
The purpose of the study was to determine the differences in the dynamics of glycemia in the first few minutes after glucose loading, because in that time the diagnostically valuable indicators that would show a statistically proven correlation with the severity of pancreatitis were supposed to be detected.
The main criteria for the selection of patients for examination were: the presence of gallstone disease, an attack of cholecystitis during the hospitalization or in the recent medical history and the presence of the pancreatic lesion syndromes.
Methods of the Research: general-clinical to clarify the diagnosis and monitor the dynamics of the disease; biochemical – determination of the level of cholecystokinin, alpha-amylase and gamma-glutamyl transpeptidase of serum; instrumental methods, such as ultrasound examination of the liver bile ducts and pancreas were used.
Results of the research and their discussion. 120 patients were examined, which were divided into 4 groups.
The results of examinations of 30 volunteers without pathology of biliary tract and pancreas were used as a control.
The age of the patients ranged from 20 to 80 years. The average age of patients with gallstone disease, complicated by acute pancreatitis was 49,6 years. Among them, females were predominant – 94 (78,3%). The largest number of patients was in the age group of 40-49 and 50-59 years old (20,8% and 18,3% respectively). There were 26 men (21,7%), the highest number of men (8 men) was in the age group of 50-59, which was 6,7%.
Conclusions:
1. An exacerbation of biliary pancreatitis in gallstone disease does not lead to complete insular insufficiency. β-cells respond adequately to the amount of glucose in the blood.
2. In acute biliary pancreatitis the violation of the dynamics of the insulin response to intravenous glucose stimulation has been confirmed. There was a certain delay in the reaction of islet cells, which was from 1 to 10 minutes.
3. The insulin response over 3 minutes shows an incretory pancreatic insufficiency in the early stages of pancreatitis.
4. Based on the findings of the study, we have proposed the use of an intravenous glucose tolerance test in the diagnosis of acute biliary pancreatitis, since its advantage is the ability to avoid the effect of the rate of absorption of glucose in the digestive tract on the result of investigation. Thus, this test reflects the adequacy of the reaction of the insulin apparatus of the pancreas to the administration of glucose.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 93421
Program Number: P250
Presentation Session: Poster Session (Non CME)
Presentation Type: Poster