Improving Treatment Strategies for Acute Pancreatitis: Advantages and Potential of Video Endoscopy
DOI:
https://doi.org/10.51699/cajmns.v7i1.3006Keywords:
acute pancreatitis, laparoscopy, videoendoscopy, ERCP, EPST, minimally invasive surgery, treatment outcomesAbstract
Acute pancreatitis remains one of the most common and severe inflammatory diseases of the abdominal cavity, accounting for approximately 25% of all acute abdominal pathologies. By comparison, acute appendicitis and acute cholecystitis account for 26% and 28%, respectively. According to global statistics, the mortality rate in acute pancreatitis ranges from 10% to 15%. The high mortality is primarily attributed to delayed medical intervention, incorrect initial diagnosis, and failure to accurately determine the stage and severity of the disease. The purpose of this study was to expand and optimize diagnostic and therapeutic capabilities of laparoscopy and videoendoscopy in patients with emergency surgery on acute pancreatitis. For our study we selected 34 patients with acute pancreatitis, 23 men 67,6% and 11 women 32,3%. From our selection 8 patients 23,5% came to the hospital from 6 to 12 hours from the beginning of the disease, 13 patients 38,2% from 12 to 24 hours, 9 patients 26,4% from 24 to 36 hours and 4 patients 11,7% after 36 hours. Eighteen patients 52,9% of our patients had the combined videoendoscopic and laparoscopic techniques applied ERCP + EPST + laparoscopy and sixteen patients 47% had a conservative therapy. Positive clinical results in our selection were performed in the vast majority of patients after minimal invasive interventions. The overall mortality rate was 11,8%, and this rate was several times lower as compared to techniques of general surgeries implemented in different surgical departments. The combined use of laparoscopy and videoendoscopic techniques enabled us to make an accurate diagnosis and effectively manage all complications of the pancreas. The combined use of videolaparoscopic and videoendoscopic techniques represents an effective, safe, and minimally invasive approach for the management of acute pancreatitis and its complications, leading to improved diagnostic accuracy, reduced postoperative complications, and better overall treatment outcomes.
References
Savelyev V.S. Emergency Surgery Guide 2008.
Savelyev V.S. Surgical diseases 2006.
Munigala S, Yadav D. Case-fatality from acute pancreatitis is decreasing, but its population mortality shows little change. Pancreatology. 2016; 16(4): 542-550.
Kurti F, Shpata V, Kuqo A, Duni A, Roshi E, Basho J. Incidence of acute pancreatitis in the Albanian population. Mater Sociomed. 2015; 27(6): 376-369.
Chamberlain_Blumberg- Hepatobilary Surgery 2002
Brekhov EI, Kalinnikov VV, Korobov MV, Sychov AV, Abrosov AE. Acute pancreatitis, рroblem overview. Kremlin medicine. Clinical Bulletin. 2015; 3: 166-174. Russian (Брехов Е.И., Kalinnikov V.V., Korobov M.V., Sыchev A.V., Abrosov A.Ye. Acute pancreatitis: a look at the problem. Kremlin medicine. Clinical bulletin. 2015. № 3. P.166-174)
Kokosis G, Perez A, Pappas TN. Surgical management of necrotizing pancreatitis: an overview. World J Gastroenterol. 2014; 20(43): 16106-16112.
. Borodin NA, Maltceva OV, Gibert BK, Zaitcev EJ. Modern approaches to the treatment of destructive forms of pancreatitis, ways to reduce mortality. Medical Science and Education of the Ural. 2015; 16: 2-1(82): 70-73. Russian (Borodin N.A., Malseva O.V., Gibert B.K., Zaysev Ye.Yu. Modern approaches to the treatment of destructive forms of pancreatitis, ways to reduce mortality // Medical Science and Education of the Urals. 2015. Т. 16, № 2-1 (82). С. 70-73).
Karakayali FY. Surgical and interventional management of complications caused by acute pancreatitis. World J Gastroenterol. 2014; 20(37): 13412-13423.
Styazhkina SN, Sitnikov VA, Ledneva AV. Acute destructive pancreatitis in urgent surgery. Bulletin of Saint Petersburg University. 2010; 5: 354-355. Russian (Styazhkina S.N., Sitnikov V.A., Ledneva A.V., Varganov M.V. Acute destructive pancreatitis in emergency surgery // Bulletin of the Saint Petersburg University. 2010. № 5. P. 354- 355)
Konstantin Frantzaydes: Laparoscopic and thoracoscopic surgery, St. Petersburg 2000
Ostrovskiy VK, Makarov SV, Smol’kina AV, Alimova RI, Nurtdinova GI, Frolov AI, et al. Pancreatic necrosis is the main cause of mortality from peritonitis outside the hospital. Modern Problems of Science and Education. 2015; 1-1: 1313. Russian (Ostrovskiy V.K., Makarov S.V., Smolkina A.V., Alimova R.I., Nurtdinova G.I., Frolov A.I., i dr. Pancreatic necrosis is the main cause of mortality in peritonitis among those who died outside the hospital // Modern Problems of Science and Education. 2015. № 1-1. С. 1313)
V.V. Boyka: Acute Pancreatitis. 2002.
L.A. Malseva, L.V. Usenko, I.V. Lyulko, N.F. Mosensev, A.O.Volkov, Abu Al Rub Baxaa El Din, N.N. Mosensev: Acute Pancreatitis
Imaeva AK, Mustafin TI, Sharifgaliev IA. Acute destructive pancreatitis. Siberian Medical Journal (Irkutsk). 2014; 131(8): 14-20. Russian (Imayeva A.K., Mustafin T.I., Sharifgaliyev I.A. Acute destructive pancreatitis // Siberian Medical Journal (Irkutsk). 2014. Т. 131, № 8. P. 14-20)
Stjazhkina SN, Protopopov VA, Darovskih AA, Akimov AA. Mortality from acute pancreatitis in the Udmurt Republic for the period 2012-2015. Journal of Scientific Articles, Health and Education in the XXI Century. 2017; 19(9): 119-121. Russian (Styajkina S.N., Protopopov V.A., Darovskix A.A., Akimov A.A Mortality from acute pancreatitis in the Udmurt Republic for the period 2012-2015 // Journal of scientific papers: Health and education in the 21st century. 2017. Т. 19, № 9. P. 119-121)
