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