Enteral insufficiency in different phases of acute pancreatitis

Abstract

Aim – to study the integral scale for assessing enteral insufficiency in patients with acute pancreatitis during the phases of enzyme toxemia and purulent-destructive complications; to develop a strategy for choosing a method for enteral insufficiency correction. Material and methods. We have analyzed the treatment outcomes in 232 patients with acute pancreatitis admitted to the surgical department of the Samara Regional Clinical Hospital n. a. V.D. Seredavin for the period from 2013 to 2019. Two study groups were formed: retrospective and prospective. The retrospective (control) group included 175 patients whose treatment outcomes were assessed retrospectively for the parameters of the enteral insufficiency syndrome and measures were suggested for its differentiated correction. The prospective (intervention) group included 57 patients who were treated using the developed principles of enteral insufficiency correction. Results. The occurrence of I and II degrees of enteral insufficiency differed significantly depending on the phase of acute pancreatitis. When using complex correction of enteral insufficiency according to the proposed scheme, in patients in the phase of enzyme toxemia the I degree enteral insufficiency was prevalent, the patients in the purulent-destructive phase were more likely to have II degree enteral insufficiency. Conclusion. The timely inclusion of enteral insufficiency correction into the complex of therapeutic measures for pancreatitis may improve the treatment outcome in patients with moderate and severe phases of acute pancreatitis.

Keywords

• enteral insufficiency syndrome
• acute pancreatitis
• multiple organ failure