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[Long-term results of severe acute pancreatitis management]
A S Ermolov1, D A Blagovestnov2, M L Rogal3
1Russian Medical Academy of Postgraduate Education; Sklifosovsky Research Institute of Emergency Care, Moscow, Russia.
Aim:
To assess the long-term results and quality of life of patients after different medical and tactical approaches in treatment of severe acute pancreatitis.
Material And Methods:
Long-term outcomes were studied in 210 patients with severe acute pancreatitis for the period 2003-2013. There were 144 (68.6%) men.
Results:
The quality of life of patients undergoing both aseptic (GIQLI - 112.9±1.3 points) and infected (GIQLI - 108.8±2.2 points) destructive complications of severe pancreatitis is lower (p=0.00001) compared with healthy population. Reccurence of acute pancreatitis was observed in 27.6% of patients. Diabetes mellitus developed in 40.5% and 23.6% of patients after infected and aseptic complications of severe pancreatitis respectively. Exocrine insufficiency was detected in 32.6% and 38.2% of patients who underwent aseptic and infected complications respectively. Postoperative hernia was observed in 30.8% of patients. Herewith, hernias (p<0.05) are predominantly formed after open operations (73,6%) than minimally invasive procedures (2.6%). Chronic pseudocyst was detected in 13.0% of patients after aseptic complications of severe pancreatitis and in 17.6% after infected complications.
Conclusion:
Quality of life and long-term outcomes are better in patients who were treated using only conservative methods and/or minimally invasive surgical interventions.
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