HOW DOES CHOLEMIA AFFECT PAIN SYNDROME COURSE IN SURGICAL PATIENTS WITH PANCREATOBILIARIC ZONE FOCAL PATHOLOGY

Abstract

The origin of pain in jaundiced patients with the cancer of the pancreatobiliary zone and chronic pancreatitis hasn’t been entirely studied yet. The aim of the study was to assess the effect of cholemia on the severity of pain syndrome in patients with surgical pathology of the pancreas. The results of surgical treatment of 54 patients with chronic pancreatitis and 218 patients with pancreatobiliary cancer complicated by obstructive jaundice were analyzed. In these patients pancreatoduodenal resection was performed. The main group patients (112 patients) have been prepared to surgery by combination of conservative measures for express detoxification and decompression of the biliary tract. The control one (160 patients) – only conservatively. The severity of pain syndrome was assessed using a visual analogue scale. In main group, the initial level of total bilirubin was 274.3±5.9 μmol/L, direct – 211.2±2.2 μmol/L, indirect – 63.4±2.6 μmol/L. In the control group – 270.6±4.6 mmol/L, 206.3±2.4 mmol/L and 64.1±2.6 mmol/L. The intensity of pain syndrome on admission was 4.9±0.4 and 5.7±0.2 points in the main and control groups, respectively. Due to the preoperative preparation, there was a slight decrease in the intensity of pain according to the visual analogue scale (4.5±0.4 points in the main and 5.4±0.3 points in the control group). In the main group, the intensity of pain decreased, respectively, from 6.4±0.3 through 5.1±0.4 to 2.8±0.4 points. In the control group – from 8.6±0.4 through 6.7±0.5 to 3.1±0.2 points. A strong positive correlation between the intensity of pain syndrome and the level of cholemia was determined (r = 0.74 in the main and r = 0.79 in the control groups).

Keywords

• cholemia
• pain syndrome
• pancreas
• chronic pancreatitis
• pancreatic cancer
• pancreatoduodenal resection