RESUMEN
An analysis of 72 criteria was made which include 5 main (hectic fever, tachycardia, leukocytosis with a neutrophilic shift to the left, decreased index of the relation of total protein to the amount of values of urea and creatinin less than 0.94 c.u., male sex), 3 additional (anemization, hypoproteinemia, decreased index of the relation of temperature to pulse rate less than 0.5 c.u.) and 1 determinant (the presence of liquid in the abdominal cavity and/or in the omental bursa and/or in the retroperitoneal space. In the presence of three of the main and one of additional signs the indications to operation are determined with probability 90.2%, and in the presence of three main and one additional and determinant--100%.
Asunto(s)
Absceso Abdominal/diagnóstico , Amilasas/sangre , Drenaje/métodos , Endoscopía del Sistema Digestivo/efectos adversos , Pancreatectomía/efectos adversos , Pancreatitis Aguda Necrotizante/complicaciones , Cirugía Asistida por Video/métodos , Absceso Abdominal/etiología , Absceso Abdominal/cirugía , Diagnóstico Diferencial , Endoscopía del Sistema Digestivo/métodos , Femenino , Estudios de Seguimiento , Humanos , Masculino , Pancreatectomía/métodos , Pancreatitis Aguda Necrotizante/enzimología , Pancreatitis Aguda Necrotizante/cirugía , Estudios RetrospectivosRESUMEN
An analysis of treatment of 260 patients with acute destructive pancreatitis (ADP) has shown that the main factors responsible for the development of purulent complications in the reactive phase of ADP are the following: pronounced and prolonged paresis of the gastro-intestinal tract, reduced function of the liver and open operations at the early stage of ADP. Prophylactic antibacterial therapy is indicated in patients having these signs as early as in the fermentative phase. If these signs are absent, prophylactic antibacterial therapy fulfilled in the fermentative phase has no effects on the frequency of the development of purulent complications in the reactive phase.