The risk factors for development of an acute biliary pancreatitis and its signs in obstruction of extrahepaic bilairy ducts

Keywords: acute biliary pancreatitis; the risk factors; obstruction of extrahepatic biliary ducts

Abstract

Objective. A search for factors, promoting development of an acute biliary pancreatitis, and peculiarities of its signs in patients, suffering obstruction of extrahepatic biliary ducts.

Materials and methods. Retrospective analysis of treatment in 283 patients, suffering obstruction of extrahepaic biliary ducts, was conducted, together with various indices analysis in patients, suffering an acute biliary pancreatitis and without acute biliary pancreatitis.

Results. An acute biliary pancreatitis was diagnosed in 30 (10.6%) patients. Trustworthy differences (p < 0.05) were revealed, concerning pronounced pain syndrome, hyperthermia, leukocytosis, young neutrophils, general bilirubin, amylase in the blood, the gallbladder volume, choledocholithiasis, the fixed calculus and stenosis of duodenal papilla magna, cholangitis. Big calculi of hepaticocholedochus did not associated with development of an acute biliary pancreatitis, and a sludge in common biliary duct and stenosis of duodenal papilla magna were characteristic for an acute biliary pancreatitis (p < 0.001).

Conclusion. Sludge of common biliary duct, stenosis and fixed calculus of duodenal papilla magna, bilirubinemia 70 mcmol/l and higher constitute the risk factors for development of an acute biliary pancreatitis, and the pronounced abdominal pain syndrome, hyperthermia, hyperamylasemia, leucocytosis, increase of the young neutrophils content up to 7% and higher, the volume of  a gallbladder 50 cm3 and more - served as the signs of an acute biliary pancreatitis in obstruction of extrahepatic biliary ducts. In obstruction of extrahepatic biliary ducts with an acute biliary pancreatitis, comparing with obstruction of extrahepatic biliary ducts without an acute biliary pancreatitis, cholangitis is revealed trustworthily: 16.7 and 5.1% accordingly (p < 0.05).

Author Biographies

I. N. Mamontov, Kharkov Medical Academy of Postgraduate Education

Mamontov Ivan Mikolayovich, MD, PhD (Med), Assistant professor
Department of surgery and proctology
Kharkiv Medical Academy of Postgraduate Education,
61037, Kharkiv, pr. Moskovsky, 197
Tel.: +38 (057) 7601166
E-mail ivan.n.mamontov@gmail.com
ORCID ID 0000-0003-0059-2715

T. I. Tamm, Kharkov Medical Academy of Postgraduate Education

Tamm Tamara Ivanivna, MD, DSci(Med), professor,
Chief of the department of surgery and proctology
Kharkiv Medical Academy of Postgraduate Education,
61037, Kharkiv, pr. Moskovsky, 197
Tel.: +38 (057) 7601166
E-mail tamm_ti@ukr.net
ORCID ID 0000-0001-6372-2092

K. A. Kramarenko, Kharkov Medical Academy of Postgraduate Education

Kramarenko Kostantin Olexandrovich, MD, PhD(Med), Assistant professor
Department of surgery and proctology
Kharkiv Medical Academy of Postgraduate Education,
61037, Kharkiv, pr. Moskovsky, 197
Tel.: +38 (057) 7601166
E-mail kakram1966@gmail.com
ORCID ID 0000-0002-1997-8928

S. G. Belov, Kharkov Medical Academy of Postgraduate Education

Belov Sergey Grigorovich, MD, DSci(Med), Professor
Department of surgery and proctology
Kharkiv Medical Academy of Postgraduate Education,
61037, Kharkiv, pr. Moskovsky, 197
Tel.: +38 (057) 7601166
E-mail byelov2304@ukr.net
ORCID ID 0000-0003-3956-2636

A. Ya. Bardiuk, Kharkov Medical Academy of Postgraduate Education

Bardiuk Olexandr Yakovlevich, MD, PhD(Med), Assistant professor
Department of surgery and proctology
Kharkiv Medical Academy of Postgraduate Education,
61037, Kharkiv, pr. Moskovsky, 197
Tel.: +38 (057) 7601166
E-mail alexjb709@ukr.net
E-mail ORCID ID 0000-0002-0069-030X

V. V. Nepomniashchyi, Kharkov Medical Academy of Postgraduate Education

Nepomniashchyi Valentin Volodimirovich, MD, PhD(Med), Assistant professor
Department of surgery and proctology
Kharkiv Medical Academy of Postgraduate Education,
61037, Kharkiv, pr. Moskovsky, 197
Tel.: +38 (057) 7601166
E-mail doktor.nep@gmail.com
E-mail ORCID ID 0000-0001-6262-6795

A. P. Zakharchuk, Kharkov Medical Academy of Postgraduate Education

Zakharchuk Oleksandr Petrovich, MD, PhD(Med), Assistant professor
Department of surgery and proctology
Kharkiv Medical Academy of Postgraduate Education,
61037, Kharkiv, pr. Moskovsky, 197
Tel.: +38 (057) 7601166
E-mail dokzakhar@gmail.com
E-mail ORCID ID 0000-0002-9023-9650

O. M. Reshetniak, Kharkov Medical Academy of Postgraduate Education

Olga Mykhailovna Reshetniak, MD, PhD(Med), Assistant professor
Department of surgery and proctology
Kharkiv Medical Academy of Postgraduate Education,
61037, Kharkiv, pr. Moskovsky, 197
Tel.: +38 (057) 7601166
E-mail metide@ukr.net
E-mail ORCID ID 0000-0002-3290-6021

E. A. Shakalova, Kharkov Medical Academy of Postgraduate Education

Shakalova Elena Anatolievna (Shakalova Olena Anatolievna)
Candidate of Medical Sciences, MD, PhD(Med), Assistant professor
Department of surgery and proctology
Kharkiv Medical Academy of Postgraduate Education,
61037, Kharkiv, pr. Moskovsky, 197
Tel.: +38 (057) 7601166
E-mail shakalova.helena@gmail.com
E-mail ORCID ID 0000-0003-3401-4278

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Published
2019-10-21
How to Cite
Mamontov, I. N., Tamm, T. I., Kramarenko, K. A., Belov, S. G., Bardiuk, A. Y., Nepomniashchyi, V. V., Zakharchuk, A. P., Reshetniak, O. M., & Shakalova, E. A. (2019). The risk factors for development of an acute biliary pancreatitis and its signs in obstruction of extrahepaic bilairy ducts . Klinicheskaia Khirurgiia, 86(10), 3-7. https://doi.org/10.26779/2522-1396.2019.10.03
Section
General Problems of Surgery