Endoscopic Transpupillary Interventions on the Main Pancreatic Duct in Acute Biliary Pancreatitis

I.M. Shevchuk, S.M. Gedzyk

Abstract


Introduction. An efficiency of using early endoscopic temporary stenting of the main pancreatic duct in the treatment of acute biliary pancreatitis is poorly studied.
The aim of the study was to evaluate the effectiveness of temporary stenting of the main pancreatic duct in acute biliary pancreatitis in combination with endoscopic papillosphincterotomy and choledocholithoextraction.
Material and Methods. Treatment outcomes of 41 patients with predicted severe course of the disease, including 29 (70.7 %) women and 12 (29.3 %) men, had been analyzed. The comparison group included 25 (60.1 %) patients who underwent papillosphincterotomy and choledocholithoextraction. In the study group in 16 (39.9 %) patients these interventions were complemented by temporary stenting of the main pancreatic duct. In all surveyed patients during first day after admission it was established 3 or more points by Ranson scale.
Results. Pancreatic necrosis occurred in 5 (20 %) patients from comparison group, of them 3 patients underwent open surgeries for subtotal pancreatic necrosis. 2 (8 %) patients died. Average time of staying in hospital was 12.84 ± 2.07 days. In study group 2 (12.5 %) were patients diagnosed with focal pancreatic necrosis, and minimally invasive interventions were successfully applied for treatment. All patients in this group are alive. Average time of staying in hospital was 7.31 ± 0.89 days (р ≤ 0.05).
Conclusion. The introduction of temporary stenting of the main pancreatic duct in patients with acute biliary pancreatitis with predicted severe course of disease helped to reduce the incidence of severe pancreatic necrosis forms, mortality and length of hospitalization.


Keywords


acute biliary pancreatitis; stenting of the main pancreatic duct

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DOI: https://doi.org/10.22141/1997-2938.2.25.2014.83059

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