PARAPANCREATITIS WITHOUT CT-SIGNS OF PANCREATIC NECROSIS IN PATIENTS WITH ACUTE PANCREATITIS
| Autor: | T. G. Dyuzheva, A. V. Shefer, E. I. Galperin, L. V. Platonova, I. A. Semenenko, E. V. Dzhus |
|---|---|
| Rok vydání: | 2018 |
| Předmět: | |
| Zdroj: | Annaly khirurgicheskoy gepatologii = Annals of HPB surgery. 21:68-72 |
| ISSN: | 2408-9524 1995-5464 |
| Popis: | Aim. To study the nature of peripancreatic lesions and its course in patients with AP without CT-signs of pancreatic necrosis. Material and Methods. We had analyzed the treatment of 38 patients with AP in whom contrast-enhanced CT did not reveal disorders of contrast accumulation by pancreatic tissue. Peripancreatic changes were assessed by presence of inhomogeneous acute necrotic collections and homogeneous acute peripancreatic fluid collections. Balthazar (2002) and K. Ishikawa et al. (2006) classification was used to estimate prevalence of parapancreatitis. Results. Acute necrotic collections were revealed in 15 patients. Balthazar index was 3.7 ± 0.1, K. Ishikawa index — 2.46 ± 0.45 on the left side and 0.86 ± 0.4 on the right side (p 0.05). Patients were discharged after 34 ± 5 days. Acute peripancreatic fluid collections were in 23 patients. Balthazar index was 2.5 ± 0.2, the gradation by Japanese classification — 1.3 ± 0.2 on the left side and 0.8 ± 0.2 on the right side. Conservative treatment was applied in 22 (96%) patients, 1 patient was exposed to percutaneous puncture. All patients were discharged after 16 ± 1 day. Conclusion. Our data evidence the importance to identify acute necrotic collections in the absence of pancreatic necrosis as a marker of peripancreatic necrosis. 33% of these patients required surgery due to infection. Classification of parapancreatitis by Kazuo Ishikawa reflects parapancreatitis development and its localization more precisely than Balthazar index. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|