[Postoperative acute pancreatitis (PAP). Direct personal experience]

Area of Science:

• Gastroenterology
• Surgical Oncology
• Pancreatology

Context:

• Investigates acute pancreatitis (APP) occurring post-interventions near the pancreas, including partial gastrectomy, papillosphincteroplasty, and duodenopancreatic procedures.
• Examines 8 cases of APP and 14 cases with direct pancreatic action to assess the role of pancreatic trauma.
• Highlights that significant amylase increases were rare, except in one APP case post-duodenopancreatic procedure.

Purpose:

• To evaluate the incidence and potential causes of acute pancreatitis (APP) following surgical procedures near the pancreas.
• To explore the hypothesis that duodenal hyperpressure and subsequent duodenal juice reflux into the pancreatic duct contribute to APP.
• To assess the efficacy of duodenal catheterization for decompression as a preventive measure against APP.

Summary:

• Presents 8 cases of APP post-pancreatic interventions, analyzing clinical stages, treatments, and outcomes.
• Investigates 14 additional cases with direct pancreatic trauma, finding minimal amylase elevation except in one post-duodenopancreatic procedure case.
• Reports successful prevention of APP in some cases by using a duodenal catheter to decompress the duodenum during procedures, suggesting it as a potential preventive method.

Impact:

• Suggests duodenal decompression via catheterization as a novel preventive strategy for acute pancreatitis (APP) after specific surgical interventions.
• Demonstrates the ineffectiveness of commonly used drugs like aprotininum and glucagonum, as well as other surgical techniques, in preventing APP.
• Underscores the high mortality rate associated with APP in this context, emphasizing the need for effective preventive measures.