A randomised study of outcome of acute pancreatitis in tertiary care hospital, Gujarat, India (retrospective study of 30 cases)

Authors

  • Jayeshkumar S. Jadav Department of General Surgery, Govt. Medical College, Surat, Gujarat, India
  • Parth H. Shah Department of Uro-Surgery, B.T. Savani Kidney Hospital, Rajkot, Gujarat, India

DOI:

https://doi.org/10.18203/2349-2902.isj20182235

Keywords:

Cholelithiasis, Complications, Lipase, Necrosis, Pancreatitis

Abstract

Background: Acute pancreatitis is common and lethal condition, often associated with one or more complications in varying degree. Aim of this study is to identify etiological factors and high-risk factors in the patients that can significantly alter the disease process and various presentations of acute pancreatitis and correlate them clinically to assess the severity of disease, to observe the clinical course of the disease, to predict beforehand the possible outcome clinically and to study the different prognostic factors evaluated on the basis of clinical assessment, serial laboratory and radiological investigations; to predict the clinical outcome of the disease, either favourable or unfavourable.

Methods: In this retrospective study of randomly selected 30 patients admitted in G. G. Hospital Jamnagar, during the period of January 2015 to July 2016 with diagnosis of acute pancreatitis were studied. Their etiological, clinical, laboratory and radiological parameters were evaluated and their association with disease severity made. Impact of various parameters which can significantly alter the disease process was identified. Some of them required surgical intervention and rest of all were managed conservatively.

Results: Most of patient (74%) recover well by conservative management. Only 26% patients required surgical management and mortality rate is 6.6% only.

Conclusions: Study shows that not all patient of acute pancreatitis need surgical interventions, rather conservative approach is preferred over surgery now a day. Etiology of pancreatitis was most of the time idiopathic followed by cholelithiasis and alcoholism. Ascites and pleural effusion are two most common complications.

References

Jensen EH, Borja-cacho D, al-Refaie, WB, Vickers SN, Sabiston. Exocrine pancreas. Textbook of Surgery, The biological basis of modern surgical practice, 19th Ed. Elsevier; 2015:1519-26.

Bhattacharya S. The pancreas, Bailey and Love’s: Short Practice of Surgery, 26th Edition, Hodder Arnold, part of Hachette livre UK; 2013(2);1139-46.

Hruban RH, Donahue CI. The pancreas. In: Kumar V, Abbas AK, Fausto N, Aster JC, Robbins and Cotran pathologic bases of disease. 8th ed. Philadelphia:Elsevier; 2013;891-904.

Clancy TE, Ashley SW. Management of Acute Pancreatitis. In: Zinner MJ, Ashley SW, Maingot’s Abdominal Operations. 12th edition. The McGraw-Hill Companies; 2013:1097-118.

Fisher WE, Anderson DK. Pancreatitis etiology and pathophysiology. In: Brunicardi (ed.) Schwartz’s Principles of Surgery. 9th edition: The McGraw-Hill Companies;2010:1178-86.

Imrie CW, Mckay CJ. Etiology, Pathogenesis and Diagnostic Assessment of Acute Pancreatitis. In: Blumgart LH. Surgery of the Liver, Biliary Tract and Pancreas.Volume 1. Section 7.4th ed. Saunders Elsevier; 2007:691-9.

Toskes PP, Greenberger NJ. Approach to the patient with pancreatic disease. In: Fauci AS, Braunwald E, Kasper DL, Hauser SL, Longo DL, Jameson JL, et al (eds.) Harrison’s Principles of Internal Medicine. 17th ed. The McGraw-Hill Companies; 2008;2(3):2001-5.

Pujari BD, Acute pancreatitis. In: Recent Advances In Surgery, Roshanlal gupta, 2nd edition. Jaypee Brothers Publication; 2012;9(13):224-39.

Bassi C, Butturini G. Definition and Classification of pancreatitis. In: Blumgart LH Surgery of the Liver, Biliary Tract and Pancreas. Volume 1. Section 7, 4th edit. Saunders Elsevier; 2007:685-90.

Suvarna R, Pallipaddy A, Bhandary N. The clinical prognostic indicators of acute pancreatitis by APACHE II score. J Clin Diagn Res. 2011;5(3):459-63.

Howard TJ. Necrosectomy for acute necrotizing pancreatitis, In: Fischer JE, Jones DB, Pomposelli FB, Upehurch GR. Fischer’s Mastery of Surgery. 6th Ed. Lippincott Williams and Wilkins; 2012(3):1417-22.

Albulushi A, Siddiqi A. Pattern of acute pancreatitis in a tertiary care center in Oman. Oman Med J. 2014;29(5):358-61.

Khanna AK, Meher S, Prakash S, Tiwary SK, Singh U, Srivastava A et al. Comparison of Ranson, Glasgow, MOSS, SIRS, BISAP, APACHE-II, CTSI Scores, IL-6, CRP and procalcitonin in predicting severity, organ failure, pancreatic necrosis and mortality in acute pancreatitis. HPB Surg. 2013;2013.

Funnell IC, Bornman PC, Weakley SP, Terblanche J, Marks IN. Obesity: an important prognostic factor in acute pancreatitis. Br J Surg. 1993;80:484-6.

Shin KY, Lee WS, Chung DW, Heo J, Jung MK, Tak WY et al. Influence of obesity on the severity and clinical outcome of acute pancreatitis. Gut Liver. 2011Sep;5(3):335-9.

Browne GW, Pitchumoni CS. Pathophysiology of pulmonary complications of acute pancreatitis. World J Gastroenterol. 2006 November;12(44): 7087-96.

Jacobs ML, Daggett MW. Acute pancreatitis, analysis of factors influencing survival. Annal Surg J. 1977;185:43-51.

Downloads

Published

2018-05-24

Issue

Section

Original Research Articles