FEATURES OF PERFORMING ABDOMINAL PARACENTESIS IN COMPLICATED COURSE OF ACUTE PANCREATITIS
DOI:
https://doi.org/10.32782/2226-2008-2023-2-10Keywords:
acute pancreatitis, complications, paracentesis, multimodal analgesiaAbstract
Introduction. Acute pancreatitis is one of the most common diseases of the abdominal cavity with a high risk of complications, the mortality rate of which can reach 70%. The aim of the work was to evaluate the effectiveness of paracentesis, drainage of the abdominal cavity using multimodal analgesia with dexketoprofen in the staged treatment of patients with complicated course of acute pancreatitis. Materials and methods. The results of the treatment of 60 patients with acute pancreatitis were analyzed, who were divided into a comparison group (n=30) – patients who received a staged approach to surgical treatment, and a main group (n=30) – patients who were additionally treated with paracentesis, drainage of the abdominal cavity from the left or right iliac region. Results. When using paracentesis with drainage of the abdominal cavity at the first stage of treatment of patients with a complicated course of acute pancreatitis, a decrease in procalcitonin indicators was obtained from 0.9±0.6 ng/ml to 0.6±0.5 ng/ml (р<0.001), interleukin-6 from 472.7±66.6 pg/ml to 417.1±82.4 pg/ml (p<0.001) and serum amylase level from 649.3±264.4 units/l to 472.7 ±168.6 units/l (р<0.001). This trend was also observed with intra-abdominal pressure indicators (from 13.6±2.9 mm Hg to 10.8±1.3 mm Hg, p=0.01). Conclusions. The use of paracentesis with drainage of the abdominal cavity as the first stage in the treatment of patients with acute pancreatitis complicated by enzymatic peritonitis leads to a significant decrease in the level of intra-abdominal pressure by 20,6%, procalcitonin by 32%, interleukin-6 by 12% and serum amylase by 27% (p<0.001). No significant difference in the frequency of infectious complications was found in the studied groups.
The article is available at the Institutional Repository of Odesa National Medical University http://journal.odmu.edu.ua/?p=7583&lang=en
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