Retrospective analysis of treatment approach of patients diagnosed with acute pancreatitis

Aim: The aim of this study was to evaluate the approaches to the treatment of patients who are followed with diagnosis of acute pancreatitis (AP).
Patients and Methods: Total of 184 patients, diagnosed with AP in our hospital between 2005-2010 were assessed retrospectively. Demographic characteristics, etiologic findings, disease severity, treatment modalities, duration of fasting, the use of antibiotics, given the total amount of daily hydration, duration of parenteral nutrition, pain treatment, prognosis and hospital stay were recorded. The relationship between treatment and the length of hospital stay and between treatment and mortality were examined. The disease were divided into
mild and severe stage according to the clinical severity.
Results: Complications developed in 27 patients (14.7%). Peripancreatic fluid accumulation in 10 patients (5.4%), pseudocys in seven patients (3.8%), pancreatic abscess in one patient (0.5%), acute renal failure in 10 patients (5.4%), and hypotension and shocked in three patients were observed. The mortality rate was 3.8% (7 cases). Antibiotic therapy was given to146 patients (79.3%) and there was no significant difference in terms of the duration of hospitalization and mortality rates between the groups of patients treated with treated with antibiotics, and not treated with antibiotics (p= 0.077, p= 0.557). When the patients who did and did not receive TPN were compared, Patients with severe cases of AP were received significantly more TPN. On the other hand, when discontinuation of oral intake and duration of hospitalization and mortality rates were compared, there was no significant difference (p= 0.182, p= 0.54).
Conclusion: AP is an important clinical problem which can be mortal. There are still many controversial treatment methods. Since empirical use of antibiotics does not affect patients’ length of hospitalization and mortality, it has been recommend only in “ed cases. The treatment of enteral or parenteral nutrition therapy should be chosen according to the severity of disease.

Akut pankreatit tanýlý hastalarda tedavi yaklaþýmýnýn retrospektif incelenmesi

Amaç: Bu çalýþmada akut pankreatit (AP) tanýsý ile takip edilen hastalarý tedavi yaklaþýmlarý açýsýndan deðerlendirmeyi amaçladýk.
Gereç ve Yöntem: 2005-2010 tarihleri arasýnda hastanemizde AP tanýsý alan 184 hasta geriye dönük olarak incelendi. Olgularýn demografik özellikleri, etyolojik bulgularý, hastalýk þiddeti, tedavi þekilleri, açlýk süreleri, antibiyotik kullanýmý, total verilen günlük hidrasyon miktarý, paranteral beslenme süresi, analjezi tedavisi, hastanede yatýþ süresi ve prognoz kaydedildi. Uygulanan tedavi yöntemleri ile hastanede kalýþ süresi ve mortalite arasýndaki iliþki incelendi. Hastalýk klinik þiddetine göre hafif ve þiddetli olarak ayrýldý.
Bulgular: Hastalarýn 27’sinde (%14,7) komplikasyon geliþti. On hastada (%5,4) peripankreatik sývý birikimi, 7 hastada (%3,8) psödokist, 1 hastada (%0,5) pankreatik abse görülürken 10 hastada (%5,4) akut renal yetmezlik, 3 hastada da hipotansiyon ve þok görüldü. Mortalite oraný %3,8 (7 olgu) bulundu. Yüzkýrkaltý hastaya (%79,3) antibiyotik tedavisi verilmiþ olup, antibiyotik verilenler ile verilmeyenler arasýnda hastanede yatýþ süresi ve mortalite oranlarý arasýnda istatistiksel fark saptanmadý (p=0,077, p=0,557). Hastalýk þiddetine göre total paranteral nutrisyon (TPN) alan ve almayan hastalar karþýlaþtýrýldýðýnda þiddetli AP olgularýnýn daha fazla TPN aldýðý istatistiksel olarak anlamlý bulundu. Oral alýmýn kesilmesiyle hastanede yatýþ süresi ve mortalite oranlarý kýyaslandýðýnda ise istatistiksel olarak anlamlý farklar
saptanmadý (p=0,182, p=0,54).
Sonuç: AP mortal seyir gösterebilen önemli bir klinik sorundur. Tedavisinde halen birçok tartýþmalý konu bulunmaktadýr. Ampirik antibiyotik kullanýmýnýn hastalarýn yatýþ süresi ve mortalitesini etkilemediðinden sadece seçilmiþ vakalarda kullanýlmasýný önermekteyiz. Enteral veya paranteral beslenme tedavisine hastalýk þiddetine göre karar verilmelidir.