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2 - Retrospective analysis of treatment approach of patients diagnosed with acute pancreatitis
Gülen Tandoğan, Belkıs Nihan Coşkun, Ayça Eroğlu, Duygu Nurdan Avcı, Kader Irak, Murat Kıyıcı
Aim: The aim of this study was to evaluate the approaches to the treatment of patients who are followed with diagnosis of acute pancreatitis (AP).
Patients and Methods: Total of 184 patients, diagnosed with AP in our hospital between 2005-2010 were assessed retrospectively. Demographic characteristics, etiologic findings, disease severity, treatment modalities, duration of fasting, the use of antibiotics, given the total amount of daily hydration, duration of parenteral nutrition, pain treatment, prognosis and hospital stay were recorded. The relationship between treatment and the length of hospital stay and between treatment and mortality were examined. The disease were divided into mild and severe stage according to the clinical severity.
Results: Complications developed in 27 patients (14.7%) . Peripancreatic fluid accumulation in 10 patients (5.4%), pseudocys in seven patients (3.8%), pancreatic abscess in one patient (0.5%), acute renal failure in 10 patients (5.4%), and hypotension and shocked in three patients were observed. The mortality rate was 3.8% (7 cases). Antibiotic therapy was given to146 patients (79.3%) and there was no significant difference in terms of the duration of hospitalization and mortality rates between the groups of patients treated with treated with antibiotics, and not treated with antibiotics (p= 0.077, p= 0.557). When the patients who did and did not receive TPN were compared, Patients with severe cases of AP were received significantly more TPN. On the other hand, when discontinuation of oral intake and duration of hospitalization and mortality rates were compared, there was no significant difference (p= 0.182, p= 0.54).
Conclusion: AP is an important clinical problem which can be mortal. There are still many controversial treatment methods. Since empirical use of antibiotics does not affect patients length of hospitalization and mortality, it has been recommend only in ed cases. The treatment of enteral or parenteral nutrition therapy should be chosen according to the severity of disease.
Keywords: Acute pancreatitis, treatment, prognosis
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