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Background. Acute pancreatitis is a disease with variable involvement of peripancreatic tissue and distal organs. Approximately 80 % of patients have mild form of the disease, edematous pancreatitis, while 15-20 % of patient develop necrotising pancreatitis with various complications. The aim of the study was to determine the etiology of the disease and to evaluate treatment in a prospective, cohort study. Patients and Methods. Enrolled were patients with acute pancreatitis treated in the period from January 1, 2005 methods to October 30, 2007. The diagnosis of was based on characteristic clinical signs and symptoms, three-fold elevation of serum amylase/lipase level and positive evidence in imaging studies. Results. In the study were included 121 patients, av. age 55.6 years, SD 16.9. The majority of them were men, 60 % (72/121), female 40 % (49/121). The predominant etiology was identified as gallstones in 52 % and alcohol in 18 %. In 14 % of patients the etiology of the disease could not be identified. According to Ranson criteria, the majority of patients, 84.3 % had a mild form of acute pancreatitis, while 15.7 had a severe form of this disease. The treatment was not successful in 4/121 patients, 3.3 % of patients died due to multiorgan failure. In 3 patients, 2.5 % a complication, a pseudocyst of the gland formed. Conclusions. Modern treatment of patients with acute pancreatitis has significantly reduced the complication rate and improved the outcome. Among our patients gallstones are the most important cause of acute pancreatitis followed by alcohol abuse. Izhodišča. Akutno vnetje trebušne slinavke lahko prizadane bližnje in oddaljene organe. Blago obliko vnetja, edematozni pankreatitis, ima okoli 80 % bolnikov, nekrotizirajočo obliko, ki poteka z zapleti, pa 15-20 %. Namen raziskave je bil opredeliti etiologijo bolezni in uspešnost zdravljenja v prospektivni kohortni raziskavi. Bolniki in metode. V raziskavo smo vključili bolnike, ki smo jih zdravili zaradi akutnega vnetja trebušne slinavke v obdobju od 1. januarja 2005 do 30. oktobra 2007 in so izpolnjevali vključitvena merila: značilno klinično sliko, trikratni porast aktivnosti amilaze/lipaze v serumu in potrditev s slikovnimi preiskavami. Rezultati. V navedenem obdobju smo zdravili 121 bolnikov povprečne starosti 55,6 leta, SD 16,9 leta. Med bolniki so prevladovali moški, 60 % (72/121), žensk je bilo 40 % (49/121). Najpogostejši vzrok bolezni so bili žolčni kamni, pri 52 % bolnikov, drugi najpogostejši vzrok, pri 18 % bolnikov, je čezmerno uživanje alkohola. Pri 14 % bolnikov tiologije bolezni nismo uspeli pojasniti. V skladu z Ransonovim točkovanjem je večina bolnikov, 84,3 %, sodila v skupino z blagim potekom vnetja žleze, pri ostalih, 15,7 %, pa je bil potek bolezni težji. Zdravljenje pri 4/121 bolnikih, 3,3 %, ni bilo uspešno, bolezen se je končala s smrtnim izidom zaradi večorganske odpovedi. Pri treh bolnikih, 2,5 %, smo potrdili zaplet akutnega vnetja žleze z razvojem psevdociste. Zaključki. Sodobni postopki zdravljenja so pomembno znižali število in vrsto zapletov ter smrtnost zaradi akutnega vnetja trebušne slinavke. Žolčni kamni in čezmerno uživanje alkohola ostajata najpomembnejša vzroka te bolezni. |
