Estimation of the efficiency ofdraining of the abdominal cavity in the complicated course of acute pancreatitis

Abstract

Introduction. Acute pancreatitis is accompanied by a high risk of complications with about 70% mortality rate. Purpose. To evaluate the effectiveness of paracentesis of abdominal cavity in treatment of patients with complicated acute pancreatitis. Materials and methods. The treatment results of 60 patients with moderate and severe acute pancreatitis with the presence of exudate in the abdominal cavity were analyzed. The patients were divided into two groups (30 people each): a standard approach was used in treating the comparison group. Paracentesis of abdominal cavity was additionally performed at the first stage of treatment in the main group. There is no significant difference in patients of each group in age, sex, etiology and severity of the disease. The effectiveness of the treatment was assessed by studying laboratory blood parameters on the first day of detecting peritoneal fluid and after 72 hours. In addition, intra-abdominal pressure was determined for the patients. We also compared the incidence of infectious complications in the late phase of the disease and the length of hospital stay. Results. A significant difference in intra-abdominal pressure and other indicators were revealed in patients in comparison group and the main group after 72 hours from the moment of detecting the liquid (17.4±2.6 and 11.4±1.6 mm Hg, p<0.001), serum amylase (774.3±233.9 and 472.7±168.6 U/L, p<0.001), procalcitonin (1.3±0.7 and 0.6±0.5 ng/mL, p<0.001) and interleukin-6 (531.3±120.9 and 417.1±82.4 pg/mL, p<0.001). Infectious complications developed in 50% of patients in the comparison group and 53.3% of patients in the main group (p>0.05). Conclusions. Early use of paracentesis of the abdominal cavity at the first stage in the treatment of patients with acute pancreatitis with enzymatic peritonitis leads to a significant decrease in the level of intra-abdominal pressure by 31%, procalcitonin by 32%, interleukin-6 by 12% and amylase 27% (p<0.001). Кeywords: acute pancreatitis, paracentesis, infectious complications