aprotinin and Acute-Disease

In this retrospective trial we assess how acute pancreatitis patients respond to nonoperative therapy; operative methods and results after surgery for acute and chronic-recurrent pancreatitis.. We present 738 acute pancreatitis patients, treated from 1991 to 2001 in our clinic. In all cases we start a nonoperative therapy comprising losses replacement, analgesics (including narcotic ones), spasmolytics, antibiotics, protease inhibitors-Contrical or Gordox (only during 1997 and 1998) and/or somatostatine (Sandostatin), H2-blockers, naso-gastric tube. Monitoring of the main parameters as blood pressure and pulse rate, number of leukocytes, values of serum amylase, urea and creatinine is performed.. 576 responded to this therapy and recovered. The ones who worsened--162 acute pancreatitis patients--underwent surgery: necrectomy followed by postoperative prolonged local lavage in the area of pancreatic couch or laparostomy. This method contributes to a prolonged evacuation of biologically active substances and devitalized tissues. The average number of Ranson's Prognostic Criteria was 4.5. Furthermore, mortality is reduced to 19%. A mortality analysis is done. Surgery (cholecystectomy and bile duct exploration) is offered to patients who recovered from acute pancreatitis caused by cholelythiasis and/or choledocholythiasis.. The majority of patients respond to the nonoperative therapy. Despite the recent improvement in diagnostics and treatment of acute pancreatitis morbidity and mortality rates are still high.

Topics: Acute Disease; Aprotinin; Female; Humans; Male; Middle Aged; Pancreatitis; Prognosis; Recurrence; Retrospective Studies; Survival Analysis; Trypsin Inhibitors

The experience in the treatment of 1800 patients with acute pancreatitis is described. Destructive forms were found in 36% of cases during the last five years. The main methods of treatment and the mortality rate following the methods used are analyzed. The authors believe cytostaticotherapy with the infusion of 5-phthoruracil into the celiac artery and forced diuresis with the infusion of fluids into the celiac artery to be the most perspective methods. The use of the above methods decreased the lethality in destructive forms to 8,3%. The intraaretrial infusion of 5-phthoruracil with antibiotics allowed coping processes of the pancreatic tissue autolysis and avoiding broad sequestration and severe suppurative complications of pancreatitis.

Topics: Acute Disease; Aprotinin; Drainage; Enzyme Inhibitors; Humans; Hypothermia, Induced; Necrosis; Pancreas; Pancreatitis; Peritoneal Dialysis; Thoracic Duct; Trypsin Inhibitors