The Role Of Laparoscopic Contact Thermometry In The Diagnosis Of Interstitial Pancreatitis

A.V. Kapshitar

Abstract


The purpose of the study: to study the temperature of the abdominal cavity in patients with interstitial pancreatitis ­using laparoscopic contact thermometry and to identify markers of this form of the disease. Material and methods. Laparoscopy was performed to 27 patients, aged from 28 to 76 years old (median of 67 years old) with interstitial pancreatitis the nature of which was unclear that made it difficult to diagnose. The accurate diagnosis was base on the results of clinical examination, biochemical indices, parameters of chest and abdominal X-ray, ECG, USD, EGDS, Acute interstitial pancreatitis was diagnosed of alcoholic origin was diagnosed in 10 (37 %) patients, biliar one was found in 8 (29.6 %) persons, traumatic — in 4 (14.8 %) patients, of unclear origin — in 5 (18.5 %) patients. Twenty four (88.9 %) patients had concomitant diseases, among them 22 persons had 2–6 pathologies. Further laparoscopic contact thermometry was carried out using electrothermometer TPEM-M and probe with sensor on it designed by us. The results were analyzed by «Statistica 6.0», mean parameters (M) and medians (ME), standard eror (m), statistic significance of mean parameters discrepancy (p). Results and discussion. The results of laparoscopic contact thermometry demonstra­ted the highest temperature in foramen epiploicum (38.1 ± 0.2 °С), me­senteric root of traverse colon (37.80 ± 0.16 °С) and omentum minus (37.70 ± 0.13 °С). These anatomic areas are close to pancreatic gland with acute pathologic process characte­rized by self-digestion and acute inflammation. The highest temperature was found in foramen epiploicum (38.1 ± 0.2 °С), and the least temperature was determined in vermicular appendix (36.40 ± 0.13 °С) with temperature difference in 1.7 °С (p < 0.001). Further clinical manifestations and the results of additional examination in dyna­mics confirmed the diagnosis of interstitial pancreatitis. All patients recovered. Conclusions. Laparoscopic symptomatology of interstitial pancreatitis is pre­sents by the indirect signs only and thus it is complicated. Diagnostic potential of the method is widened due to the abdominal lapascopic contact thermometry. The highest temperature was found in pancreatic area (foramen epiploicum, mesenteric root of traverse colon, omentum minus) that could be a marker of interstitial pancreatitis.


Keywords


pancreatitis; laparoscopy; diagnosis

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DOI: https://doi.org/10.22141/1997-2938.1-2.30-31.2016.78107

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