engleski

MANAGEMENT OF ACUTE PANCREATITIS - RETROSPECTIVE ANALYSIS

Acute necrotizing pancreatitis is a serious illness burdened with high incidence of septical complications and a consequent mortality rate of over 30%. Several scoring systems have been developed for predicting the severity of acute pancreatitis (mortality rate and infective complications). 49 patients with severe acute pancreatitis treated at the Department of Surgery from 1995 to 2000 were analyzed. There were 24 (49%) women and 25 (51%) men. Mean age was 56.4 (15.3) years. Alcohol was the cause of acute pancreatitis in 4 (8%) patients, cholelithiasis in 13 (27%), other causes in 3 (6%) and unknown in remaining 29 (59%) patients. APACHE II score was a sensitive predictor of mortality (p<0.01) and infectious complications (p<0.01). APACHE II score was significantly hjgher in patients who died (mean 12.6, SD 5.04) compared to those who survived (mean 6.4, SD 4.01)(p<0.001). Ranson's criteria were found to be less sensitive that APACHE II score in predicting outcome and infectious complications. Mortality rate of patients with necrosis proven by CT was 31.8% and it was 11.1 % in those patients without radiological signs of pancreatic necrosis. Indication for surgery should rely on laboratory and radiological signs of pancreatic necrosis.

Acute pancreatitis; therapy; APACHE II score

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