Akut pankreatit olgularının kanıta dayalı tıp kılavuzları rehberliğinde incelenmesi

Abstract

Background/aim: In this study 177 consecutive cases with either interstitial or severe pancreatitis were evaluated retrospectively in the light of IAP guidelines. We tried to define compatibility of our results with recently published IAP recommendations. Materials and methods: All patients were recorded into the Ege University Acute Pancreatitis Database (EUAPD) between 1998 and 2004. In this form, variables were: etiology, age, body mass index (BMI), serum amylase levels (IU/L), serum bilirubin levels (mg/dl), leukocyte counts (/mm3), fever (°C), serum creatinine levels (mg/dl), serum C-reactive protein (CRP) levels (mg/dl), Ranson score at admission, APACHE II score at admission, and MPI, retrospectively. Timing of ERCP, diagnostic tools used and antibiotics preferred were also recorded. Severe patients with necrosis were referred for either surgical or laparoscopic/CT-guided drainage plus peritoneal lavage procedure. Results in both severe and edematous groups were compared to IAP guideline recommendations. Diagnostic and therapeutic algorithms have been defined for our institution based on these findings. Results: 151(85.3%) interstitial edematous pancreatitis (IEP) and 26(14.7%) severe pancreatitis (SP) cases were evaluated. The most leading etiological factor was biliary stone in IEP (n= 112, 74.6%) and SP (n=22, 85%). BMI, Ranson, APACHE II and MPI scores in both groups were 25.9/25.74; 1.88/ 2.78; 4.68/12.24 (p