Estimation of efficacy of the plasmapheresis application in complex therapy of an acute necrotic pancreatitis

Keywords: acutenecrotic pancreatitis; іntoxication; plasmapheresis

Abstract

Objective. To study up the impact of plasmapheresis (PPH) on laboratory indices of intoxication and inflammatory process in patients, suffering an acute necrotic pancreatitis (ANP).

Маterials and methods. In the investigation 73 patients, suffering an ANP, were included. The Control Group have consisted of 27 patients, who obtained intensive medicinal therapy. The Main Group have included 46 patients, in whom a standard intensive therapy was added by PPH. Besides conventional tests, the indices of intoxication and markers of inflammation were studied.

Results. In patients of the Main Group the indices of intoxication and inflammation already after first s ance of PPH were trustworthily lower, than the analogous indices in patients of a Control Group. For those patients, in whom the indices noted have approximated the analogous indices of healthy persons, the decision was accepted to do the only one s ance of PPH. While in the other patients were conducted two аnd in some – even three s ances of PPH. After secondary s ances of PPH the indices of intoxication and inflammation in patients of the Main Group have been trustworthily differed from not only analogous indices in patients of the Control Group, but as well as from the indices in patients, to whom the only one s ance of extracorporeal detoxication was conducted.

Conclusion. PPH reduces clinical signs of pancreatitis, аs well as the laboratory indices of intoxication and inflammatory process.

Author Biographies

K. Y. Ishcheikin, Ukrainian MedicalStomatologicalAcademy, Poltava

Ishcheikin Kostiantyn Y. - MD, DSci (Med), Professor,
Department of Internal Medicine and Emergency Medicine with skin and venereal diseases,
Ukrainian Medical Stomatological Academy,
23 Shevchenko Str., 36011, Poltava, Ukraine
+38-05322-2-14-50
mail@umsa.edu.ua
https://orcid.org/0000-0001-7887-0995

D. I. Grebeniuk, PyrogovNationalMedicalUniversity, Vinnytsya

Grebeniuk Dmytro I. - MD, PhD (Med), Associate Professor,
Department of Endoscopic and Cardiovascular Surgery,
National Pirogov Memorial Medical University, Vinnytsya
56 Pirogov Str., 21018, Vinnitsa, Ukraine
+38-067-595-44-83
Doctor.Svo@gmail.com
https://orcid.org/0000-0002-6760-7494

O. M. Zatserkovna, PyrogovNationalMedicalUniversity, Vinnytsya

Zatserkovna Olena M. - MD, Assistant,
Department of Endoscopic and Cardiovascular Surgery
National Pirogov Memorial Medical University, Vinnytsya
56 Pirogov Str., 21018, Vinnitsa, Ukraine
+38-0432-57-03-60
zatserkovna.olena@gmail.com
https://orcid.org/0000-0002-1251-2359

I. V. Taran, PyrogovNationalMedicalUniversity, Vinnytsya

Taran Illia V. - MD, PhD (Med), Associate Professor,
Department of Pharmacology,
National Pirogov Memorial Medical University, Vinnytsya
56 Pirogov Str., 21018, Vinnitsa, Ukraine
+38-097-450-97-70
Scienceandroid@gmail.com
https://orcid.org/0000-0003-0488-6083

K. M. Pankiv, PyrogovNationalMedicalUniversity, Vinnytsya

Pankiv Kateryna M. - MD, Assistant,
Department of Endoscopic and Cardiovascular Surgery,
National Pirogov Memorial Medical University, Vinnytsya
56 Pirogov Str., 21018, Vinnitsa, Ukraine
+38-063-856-78-98
kateryna.pankiv@gmail.com
https://orcid.org/0000-0002-5011-9689

References

1. Chua TY, Walsh RM, Baker ME, Stevens T. Necrotizing pancreatitis: Diagnose, treat, consult. Cleve Clin J Med. 2017 Aug;84(8):639-648. https://doi.org/10.3949/ccjm.84a.16052.
2. Maheshwari R, Subramanian RM. Severe Acute Pancreatitis and Necrotizing Pancreatitis. Crit Care Clin. 2016 Apr;32(2):279-90. doi: 10.1016/j.ccc.2015.12.006.
3. Portelli M, Jones CD. Severe acute pancreatitis: pathogenesis, diagnosis and surgical management. Hepatobiliary Pancreat Dis Int. 2017 Apr;16(2):155-9. PMID: 28381378.
4. Hong B, Ling Z, Songmin H, Tao Z, Ruichao Y. Continuous venovenous hemofiltration and hemoperfusion in successful treatment of a patient with crush syndrome and acute pancreatitis. Ren Fail. 2012;34(3):383-6. https://doi.org/10.3109/0886022X.2011.647370.
5. Huang SP, Toh DE, Sue YM, Chen TH, Cheng SW, Cheng CY. Double filtration plasmapheresis in treatment of acute pancreatitis associated with severe hypertriglyceridemia: Three case reports. Medicine (Baltimore). 2018 Nov;97(44):e12987. https://doi.org/10.1097/MD.0000000000012987.
6. Uyar S, Harmandar F, Kok M, Ta? Z, Dolu S, Tokuc A, et al. Management of hypertriglyceridemia induced acute pancreatitis and therapeutic plasmapheresis: Report of nine cases and review of literature. Acta Gastroenterol Belg. 2017 Jan-Mar;80(1):71-4. PMID: 29364102.
Published
2019-05-17
Section
General Problems of Surgery