Email this article Enteral insufficiency in different phases of acute pancreatitis
- Authors: Korymasov E.A.1, Ivanov S.A.1, Kenarskaya M.V.2, Khoroshilov M.Y.2, Zhdanov A.V.1,3, Anorev N.I.1, Yakovlev R.R.1, Maksimov D.V.1
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Affiliations:
- Samara State Medical University
- Samara Regional Clinical Hospital named after V.D. Seredavin
- Clinical hospital RZD Medicine
- Issue: Vol 8, No 4 (2023)
- Pages: 300-306
- Section: Surgery
- URL: https://ogarev-online.ru/2500-1388/article/view/232077
- DOI: https://doi.org/10.35693/2500-1388-2023-8-4-300-306
- ID: 232077
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Abstract
Aim – to study the integral scale for assessing enteral insufficiency in patients with acute pancreatitis during the phases of enzyme toxemia and purulent-destructive complications; to develop a strategy for choosing a method for enteral insufficiency correction.
Material and methods. We have analyzed the treatment outcomes in 232 patients with acute pancreatitis admitted to the surgical department of the Samara Regional Clinical Hospital n. a. V.D. Seredavin for the period from 2013 to 2019. Two study groups were formed: retrospective and prospective. The retrospective (control) group included 175 patients whose treatment outcomes were assessed retrospectively for the parameters of the enteral insufficiency syndrome and measures were suggested for its differentiated correction. The prospective (intervention) group included 57 patients who were treated using the developed principles of enteral insufficiency correction.
Results. The occurrence of I and II degrees of enteral insufficiency differed significantly depending on the phase of acute pancreatitis. When using complex correction of enteral insufficiency according to the proposed scheme, in patients in the phase of enzyme toxemia the I degree enteral insufficiency was prevalent, the patients in the purulent-destructive phase were more likely to have II degree enteral insufficiency.
Conclusion. The timely inclusion of enteral insufficiency correction into the complex of therapeutic measures for pancreatitis may improve the treatment outcome in patients with moderate and severe phases of acute pancreatitis.
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##article.viewOnOriginalSite##About the authors
Evgenii A. Korymasov
Samara State Medical University
Email: e.a.korymasov@samsmu.ru
ORCID iD: 0000-0001-9732-5212
PhD, Professor, Head of the Department of Surgery of the Institute of Postgraduate Education
Russian Federation, 89 Chapaevskaya st., Samara, 443099Sergey A. Ivanov
Samara State Medical University
Email: docisa@mail.ru
ORCID iD: 0000-0001-7131-3985
PhD, Professor, Department of Surgery of the Institute of Postgraduate Education
Russian Federation, 89 Chapaevskaya st., Samara, 443099Mariya V. Kenarskaya
Samara Regional Clinical Hospital named after V.D. Seredavin
Email: mary.kenarskaya@gmail.com
ORCID iD: 0000-0003-1812-4143
a surgeon
Russian Federation, 159 Tashkentskaya st., Samara, 443095Maksim Yu. Khoroshilov
Samara Regional Clinical Hospital named after V.D. Seredavin
Email: khor-maksim@yandex.ru
ORCID iD: 0000-0002-9659-8881
a surgeon
Russian Federation, 159 Tashkentskaya st., Samara, 443095Aleksei V. Zhdanov
Samara State Medical University; Clinical hospital RZD Medicine
Email: doctor_zhdanov86@mail.ru
ORCID iD: 0000-0002-8594-7660
assistant of the Department of Surgery of the Institute of Postgraduate Education, Head of the Endoscopy Department
Russian Federation, 89 Chapaevskaya st., Samara, 443099; SamaraNikita I. Anorev
Samara State Medical University
Author for correspondence.
Email: nikitaanorev@yandex.ru
ORCID iD: 0000-0001-6315-4419
a postgraduate student of the Department of Surgery of the Institute of Postgraduate Education
Russian Federation, 89 Chapaevskaya st., Samara, 443099Roman R. Yakovlev
Samara State Medical University
Email: he-roma@yandex.ru
ORCID iD: 0000-0001-5887-3048
a postgraduate student of the Department of Surgery of the Institute of Postgraduate Education
Russian Federation, 89 Chapaevskaya st., Samara, 443099Dmitrii V. Maksimov
Samara State Medical University
Email: maxxximov22@gmail.com
a resident of the Department of Surgery of the Institute of Postgraduate Education
Russian Federation, 89 Chapaevskaya st., Samara, 443099References
- Savelyev VS, Filimonov MI, Burnevich SZ. Pancreatic necrosis. M., 2008. (In Russ.). [Савельев В.С., Филимонов М.И., Бурневич С.З. Панкреонекрозы. М., 2008].
- Maev IV. Diseases of the pancreas: a practical guide. M., 2009. (In Russ.). [Маев И.В. Болезни поджелудочной железы: практическое руководство. М., 2009].
- Isaji S, Takada T, Mayumi T, et al. Revised Japanese guidelines for the management of acute pancreatitis 2015: revised concepts and updated points. Journal of Hepato-Biliary-Pancreatic Sciences. 2015;22(6):433-445. doi: 10.1002/jhbp.260
- Dellinger RP. Surviving Sepsis Campaign: international guidelines for management of severe sepsis and septic shock. Critical Care Medicine. 2008;36(1):296-327.
- Balk R. Pathogenesis and management of multiple organ dysfunction or failure in severe sepsis and septic shock. Crit Care Clin. 2000;16(9):337-350.
- Kenarskaya MV, Ivanov AR, Ivanov SA. Program for determining the degree of enteral insufficiency in chronic patients. Patent RF №2019612419. (In Russ.). [Кенарская М.В., Иванов А.Р., Иванов С.А. Программа для определения степени энтеральной недостаточности у пациентов хирургического профиля. Патент РФ №2019612419].
- Korymasov EA, Ivanov SA, Kenarskaya MV, Anorev NI. Surgical strategy for suppurative complications of pancreatic necrosis. Surgery. Journal named after Pirogov. 2021;6:10-18. (In Russ.). [Корымасов Е.А., Иванов С.А., Кенарская М.В., Анорьев Н.И. Выбор хирургического доступа в лечении гнойных осложнений. Хирургия. Журнал имени Н.И. Пирогова. 2021;6:10-18]. doi: 10.17116/hirurgia202106110
- Anorev NI, Ivanov SA. Treatment algorithm for patients with infected pancreonecrosis. In: Postgraduate readings SamSMU. 2021:4-6. (In Russ.). [Анорьев Н.И., Иванов С.А. Лечебный алгоритм у пациентов с инфицированным панкреонекрозом. В кн.: Аспирантские чтения СамГМУ. 2021:4-6].
- Capurso G, Zerboni G, Signoretti M, et al. Role of the gut barrier in acute pancreatitis. J Clin Gastroenterol. 2012;46:46-51.
- Grant JP. Nutritional support in acute and chronic pancreatitis. Surg Clin North Am. 2011;4:805-20.
- Ali-Zade SG, Nazarov ShK, Kholmatov PK, Dodikhudoev RA. Complex diagnostics and methods of treatment of the syndrome of enteral insufficiency in patients with acute pancreatitis. Avicenna Bulletin. 2019;21(1):136-40. (In Russ.). [Али-Заде С.Г., Назаров Ш.К., Холматов П.К., Додихудоев Р.А. Комплексная диагностика и методы лечения синдрома энтеральной недостаточности у пациентов с острым панкреатитом. Вестник Авиценны. 2019;21(1):136-40]. doi: 10.25005/2074-0581-2019- 21-1-136-140
- Wu XM, Ji KQ, Wang HY, et al. Total enteral nutrition in prevention of pancreatic necrotic infection in severe acute pancreatitis. Pancreas. 2010;39(2):248-51.
- Koh YY, Jeon WK, Cho YK, et al. The effect of intestinal permeability and endotoxemia on the prognosis of acute pancreatitis. Gut Liver. 2012;6:505-11.
- Rummo OO. Intraintestinal therapy of enteral insufficiency syndrome in peritonitis, intestinal obstruction and destructive pancreatitis. Meditsinskiy zhurnal. 2009;2:15-9. (In Russ.). [Руммо ОО. Интраинтестинальная терапия синдрома энтеральной недостаточности при перитоните, кишечной непроходимости и деструктивном панкреатите. Медицинский журнал. 2009;2:15-9].
- Chen Y, Zhao Q, Chen Q. Melatonin attenuated inflammatory reaction by inhibiting the activation of p38 and NF-κB in taurocholate-induced acute pancreatitis. Mol Med Rep. 2018;17(4):5934-5939.
- Dyuzheva TG, Shefer AV, Semenenko IA, Shmushkovich TB. Widespread parapancreatitis determines the severity of patients with acute pancreatitis in the first week of the disease. Moscow Surgical Journal. 2018;(3):7-8. (In Russ.). [Дюжева Т.Г., Шефер А.В., Семененко И.А., Шмушкович Т.Б. Распространенный парапанкреатит определяет тяжесть больных острым панкреатитом в первую неделю заболевания. Московский хирургический журнал. 2018;3:7-8].
- Dibirov MD. Treatment of intestinal insufficiency syndrome with pancreatic necrosis. Effektivnaya farmakoterapiya. 2013;8:28-33. (In Russ.). [Дибиров М.Д. Лечение синдрома кишечной недостаточности при панкреонекрозе. Эффективная фармакотерапия. 2013;8:28-33].
- Bagnenko SF, Goltsov VR. Acute pancreatitis - current state of the problem and outstanding issues. Al'manah Instituta hirurgii im. A.V. Vishnevskogo. 2008;3(3):104-112. (In Russ.). [Багненко С.Ф., Гольцов В.Р. Острый панкреатит – современное состояние проблемы и нерешенные вопросы. Альманах Института хирургии им. А.В. Вишневского. 2008;3(3):104-112].
- Pugaev AV, Achkasov EE. Acute pancreatitis. M., 2019. (In Russ.). [Пугаев А.В., Ачкасов Е.Е. Острый панкреатит. М., 2019].
- Myl'nikov AG, Shapoval’yants SG, Pan'kov AG, Korolev SV. The enteral tube feeding and selective intestinal decontamination for the treatment of the acute pancreatitis. Pirogov Russian Journal of Surgery. 2012;(2):37 41. (In Russ.). [Мыльников А.Г., Шаповальянц С.Г., Паньков А.Г., Королев С.В. Энтеральное зондовое питание и селективная деконтаминация желудочно-кишечного тракта в лечении острого деструктивного панкреатита. Хирургия. Журнал им. Н.И. Пирогова. 2012;(2):37 41].
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