Exocrine secretion oppression as game changing tool in acute pancreatitis surgical treatment

Authors

  • S. E. Podpryatov Kyiv Municipal Hospital No. 1
  • O. V. Ivanko Kyiv Municipal Hospital No. 1
  • S. S. Popdryatov Kyiv Municipal Hospital No. 1
  • O. V. Levytska Kyiv Municipal Hospital No. 1
  • V. P. Korchak Kyiv Municipal Hospital No. 1

DOI:

https://doi.org/10.11603/2414-4533.2023.2.13989

Keywords:

acute pancreatitis, octreotide, surgical treatment changes

Abstract

the aim of the work: to assess changes in tactic of surgical treatment of acute destructive pancreatitis (ADP) due to octreotide prescription in high dose 1 mg/day (OHD).

Materials and Methods. OHD had been used as treatment of 6 patients with ADP. Within first two days of illness in such way were treated 4 patients (group1), in terms of two weeks after disease beginning OHD treatment had been applied to 2 patients (group2). All patients gave an informed consent to applied treatment.

There were 2 women and 4 men in the age from 17 to 75 years. Gallstone disease combined with excessive eating lied ground to ADP outbreak in 2 patients, alcohol excessive consumption combined with overeating in 4.

In our observations acute pancreatitis was diagnosed on integrated assessing results of clinical appearances, and results of laboratory and instrumental examining. OHD had been prescribed to every patient immediately after the diagnosis had been stated.

Results and Discussion. All patients from group 1 became free from clinical signs of ADP two hours after OHD administering. Prolongation of the OHD use during next two days resulted in normalizing of general clinical state and amylase level. In one patient after two days of OHD treatment clinical signs didn’t normalized. There left some abdominal pain and substantial meteorism.

Both patients from group 2 obtain stabilization of general clinical status with the clear expression a sign of a local abscess. By means of computed and magnetic tomography almost two local niduses in every patient had been localized and subsequently subjected it to healing through a mini-invasion approach. Both patients recovered.

Conclusion. Thus, we can suggest that proposed method of OHD treatment cause stabilization of pancreatic parenchyma what may be the reason for observed immediate break of inflammation.

 

References

Colvin, S.D., Smith, E.N., Morgan, D.E., & Porter, K.K. (2020). Acute pancreatitis: an update on the revised Atlanta classification. Abdom. Radiol. (NY), 45 (5): 1222-1231. DOI: 10.1007/s00261-019-02214-w. DOI: https://doi.org/10.1007/s00261-019-02214-w

Bhatti, K.M., Rehman, S., Ahmed, S.E., & Canelo, R. (2022). Management of complicated acute pancreatitis: the role of hub-and-spoke model. J. Coll. Physicians Surg. Pak., 32 (5): 575-580. DOI: 0.29271/jcpsp.2022.05.575. DOI: https://doi.org/10.29271/jcpsp.2022.05.575

Karakoyunlar, O., Sivrel, E., Tanir, N., & Deneçli, A. G. (1999). High dose octreotide in the management of acute pancreatitis. Hepatogastroenterology, 46(27), 1968-1972.

Nikou, G.C., Arnaoutis, T.P., Giamarellos-Bourboulis, E.J., Samolada, O., Vafiadis-Zouboulis, I., Katsilambros, N., & Arvanitakis, C. (2001). The significance of the dosage adjustment of octreotide in the treatment of acute pancreatitis of moderate severity. Hepatogastroenterology, 48 (42), 1754-1757.

Meng, L., Wu, Z., & Zhang, H. (2019). Effect of ulinastatin combined with octreotide on serum endothelin, endotoxin levels and immune function in acute pancreatitis. J. Coll. Physicians Surg. Pak., 29 (1): 90-92. DOI: 10.29271/jcpsp.2019.01.90. DOI: https://doi.org/10.29271/jcpsp.2019.01.90

Rasch, S., Pichlmeier, E. M., Phillip, V., Mayr, U., Schmid, R. M., Huber, W., & Lahmer, T. (2022). Prediction of outcome in acute pancreatitis by the qSOFA and the New ERAP Score. Dig. Dis. Sci., 67 (4), 1371-1378. DOI: 10.1007/s10620-021-06945-z. DOI: https://doi.org/10.1007/s10620-021-06945-z

Mederos, M.A., Reber, H.A., & Mark D. (2020). Girgis acute pancreatitis: A review. JAMA, 325(4):382-390. DOI: 10.1001/jama.2020.20317. DOI: https://doi.org/10.1001/jama.2020.20317

Oppenlander, K.E., Chadwick, C., & Carman, K. (2022). Acute pancreatitis: Rapid evidence review. Am. Fam. Physician, 106 (1), 44-50.

Cienfuegos, J.A., Valentí, V., & Rotellar, F. (2022). Acute pancreatitis: an opportunity for gastroenterology hospitalists? Rev. Esp. Enferm. Dig., 114 (2), 73-75. DOI: 10.17235/reed.2022.8573/2022. DOI: https://doi.org/10.17235/reed.2022.8573/2022

Seppänen, H., & Puolakkainen, P. (2020). Classification, severity assessment, and prevention of recurrences in acute pancreatitis. Scand. J. Surg.,109 (1), 53-58. DOI: 10.1177/1457496920910007. DOI: https://doi.org/10.1177/1457496920910007

Wessling, J., Peitz, U., Hoffmann, M., Schreyer A. G., & Grenacher, L. (2021). Acute pancreatitis: Typical findings in computed tomography and magnetic resonance imaging. [Article in German]. Radiologe, 61 (6), 532-540. DOI: 10.1007/s00117-021-00854-y. DOI: https://doi.org/10.1007/s00117-021-00854-y

Hamm, R.G. (2021). Acute Pancreatitis: causation, diagnosis, and classification using computed tomography. Radiol. Technol., 93 (2), 197CT-219CT.

Leppäniemi, A., Tolonen, M., Tarasconi, A., Segovia-Lohse, H., Gamberini, E., Kirkpatrick, A. W., Ball, C. G., Parry, N., Sartelli, M., Wolbrink, D., Goor, H., Baiocchi, G., Ansaloni, L., Biffl, W., Coccolini, F., Saverio, S.D., Kluger, Y., Moore, E., & Catena, F. (2020). 2019 WSES guidelines for the management of severe acute pancreatitis Scand. J. Surg., 109 (1), 53-58. DOI: 10.1177/1457496920910007. DOI: https://doi.org/10.1186/s13017-019-0247-0

Machicado, J.,D., & Yadav, D. (2017). Epidemiology of recurrent acute and chronic pancreatitis: similarities and differences review. Dig. Dis. Sci., 62 (7): 1683-1691. DOI: 10.1007/s10620-017-4510-5. DOI: https://doi.org/10.1007/s10620-017-4510-5

Published

2023-07-25

How to Cite

Podpryatov, S. E., Ivanko, O. V., Popdryatov, S. S., Levytska, O. V., & Korchak, V. P. (2023). Exocrine secretion oppression as game changing tool in acute pancreatitis surgical treatment. Hospital Surgery. Journal Named by L.Ya. Kovalchuk, (2), 34–38. https://doi.org/10.11603/2414-4533.2023.2.13989

Issue

Section

ORIGINAL INVESTIGATIONS