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acute pancreatitis, acute peripancreatic fluid collection, intra-abdominal hypertension, paracentesis

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Kolosovych, I., & Hanol , I. (2022). FACTORS INCREASING INTRA-ABDOMINAL PRESSURE IN PATIENTS WITH A COMPLICATED COURSE OF ACUTE PANCREATITIS. Medical Science of Ukraine (MSU), 18(4), 31-36. https://doi.org/10.32345/2664-4738.4.2022.05


Relevance. The frequency of development of intra-abdominal hypertension in patients with a complicated course of acute pancreatitis is 60-70% and leads to an increase in the mortality rate up to 62%. Acute peripancreatic fluid collection, occurring in 65.2-88.9% of patients with moderate and severe acute pancreatitis in the early period of the disease, is one of the causes of increased intra-abdominal pressure.

Objective: to assess the effect of acute peripancreatic fluid collection on intra-abdominal pressure and the effectiveness of paracentesis with drainage of the abdominal cavity as a method of treatment of intra-abdominal hypertension in patients with complicated course of acute pancreatitis in the early period of the disease.

Methods. The study included 60 patients with a complicated course of acute pancreatitis, who were divided into two groups depending on the features of the selected treatment tactics: the main group (paracentesis, drainage of the abdominal cavity was additionally performed) – 30 patients, the comparison group (conservative therapy was applied) - 30 patients. Intra-abdominal pressure indicators were compared in the studied groups and performed a comparative analysis of the dependence of its changes on the amount of exudate removed from the abdominal cavity.

Results. When using paracentesis and drainage of the abdominal cavity in the early period in patients with a complicated course of acute pancreatitis, a significant difference was obtained between the intra-abdominal pressure indicators in the studied groups after one day (8.7±1.5 vs. 14.7±3.3 mm Hg (p<0.0001)) and after 7 days (10.5±1.3 vs. 12.7±2.5 mm Hg (p=0.0001)). In the patients of the main group, a decrease in intra-abdominal pressure was observed on the first day after paracentesis, followed by an increase after three days and stabilization after 6 days, and an average negative correlation was found between the amount of exudate removed from the abdominal cavity and changes in intra-abdominal pressure with the Pearson coefficient r = - 0.4418.

Conclusions. The use of paracentesis, drainage of the abdominal cavity in patients with complicated course of acute pancreatitis in the early period of the disease can be considered as a safe and effective method of treatment of intra-abdominal hypertension in this category of patients.

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Lee AHH, Lee WS, Anderson D. Severe pancreatitis complicated by abdominal compartment syndrome managed with decompressive laparotomy: a case report. BMC Surg. 2019 Aug 17;19(1):113. DOI: 10.1186/s12893-019-0575-8.

View at:

Publisher Site: https://bmcsurg.biomedcentral.com/articles/10.1186/s12893-019-0575-8

PubMed: https://pubmed.ncbi.nlm.nih.gov/31419970/

PubMed Central: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6697923/

Leon M, Chavez L, Surani S. Abdominal compartment syndrome among surgical patients. World J Gastrointest Surg. 2021 Apr 27;13(4):330-339. DOI: 10.4240/wjgs.v13.i4.330.

View at:

Publisher Site: https://www.wjgnet.com/1948-9366/full/v13/i4/330.htm

PubMed: https://pubmed.ncbi.nlm.nih.gov/33968300/

PubMed Central: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8069070/

Wu H, Ma K, Liao B, Ji T, Zhang S, Cao T. Comparative Analysis of Early Clinical Features and Complications of Different Types of Acute Pancreatitis. Oxid Med Cell Longev. 2022 Jun 25;2022:3771610. DOI: 10.1155/2022/3771610.

View at:

Publisher Site: https://www.hindawi.com/journals/omcl/2022/3771610/

PubMed: https://pubmed.ncbi.nlm.nih.gov/35795856/

PubMed Central: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9252761/

Boxhoorn L, Voermans RP, Bouwense SA, Bruno MJ, Verdonk RC, Boermeester MA, van Santvoort HC, Besselink MG. Acute pancreatitis. Lancet. 2020 Sep 5;396(10252):726-734. DOI: 10.1016/S0140-6736(20)31310-6.

View at:

Publisher Site: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31310-6/fulltext

PubMed: https://pubmed.ncbi.nlm.nih.gov/32891214/

Lu Z, Zhu X, Hua T, Zhang J, Xiao W, Jia D, Yang M. Efficacy and safety of abdominal paracentesis drainage on patients with acute pancreatitis: a systematic review and meta-analysis. BMJ Open. 2021 Aug 9;11(8):e045031. DOI: 10.1136/bmjopen-2020-045031.

View at:

Publisher Site: https://bmjopen.bmj.com/content/11/8/e045031

PubMed: https://pubmed.ncbi.nlm.nih.gov/34373293/

PubMed Central: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8354272/

Acute pancreatitis. Adapted evidence-based clinical practice. Kyiv: "State Expert Center of the Ministry of Health of Ukraine", 2014. 68 p. [in Ukrainian]

View at:

URL: http://vnmed3.kharkiv.ua/wp-content/uploads/2015/03/chronic_pancreatitis.pdf

Kolosovych IV, Bezrodnyi BH, Hanol IV, Cherepenko IV. Stage approach in surgical treatment of acute pancreatitis. Med. perspekt. 2020Jul.1;25(2):124-9. [in Ukrainian]. DOI: 10.26641/2307-0404.2020.2.206384

View at:

Publisher Site: https://medpers.dmu.edu.ua/2020-tom-xxv/n-2#kolosovych-iv-bezrodnyi-bh-hanol-iv-cherepenko-iv-etapnyi-pidkhid-u-khirurhichnomu-likuvanni-hostroho-pankreatytu

URL: https://medpers.dmu.edu.ua/issues/2020/N2/124-129.pdf

Kolosovych IV, Hanol IV, Cherepenko IV, Lebedieva KO, Korolova KO. Іntrabdominal pressure and its correction in acute surgical pathology. Wiad Lek. 2022;75(2):372-376.

View at:

PubMed: https://pubmed.ncbi.nlm.nih.gov/35307661/

Păduraru DN, Andronic O, Mușat F, Bolocan A, Dumitrașcu MC, Ion D. Abdominal Compartment Syndrome-When Is Surgical Decompression Needed? Diagnostics (Basel). 2021 Dec 7;11(12):2294. DOI: 10.3390/diagnostics11122294.

View at:

Publisher Site: https://www.mdpi.com/2075-4418/11/12/2294

PubMed: https://pubmed.ncbi.nlm.nih.gov/34943530/

PubMed Central: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8700353/

Mancilla Asencio C, Berger Fleiszig Z. Intra-Abdominal Hypertension: A Systemic Complication of Severe Acute Pancreatitis. Medicina (Kaunas). 2022 Jun 10;58(6):785. DOI: 10.3390/medicina58060785.

View at:

Publisher Site: https://www.mdpi.com/1648-9144/58/6/785

PubMed: https://pubmed.ncbi.nlm.nih.gov/35744049/

PubMed Central: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9229825/

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