Clinical aspects of diagnosis and prognosis of acute necrotic pancreatitis

Abstract

Aim - to evaluate diagnostic markers of acute pancreatitis. Materials and methods. The study was conducted in the period from 2014 to 2023 and was based on the assessment of the severity of acute pancreatitis (AP) in 237 patients. All patients were divided due to the severity of AP. Mild AP was detected in 85 (35.86%), moderate - in 90 (37.97%), severe - in 44 (18.56%), critical - in 18 (7.59%) patients. Also, two study groups were formed: the Group 1 (patients with mild and moderate AP) and the Group 2 (severe and critical AP). Results. The level of procalcitonin in the blood was increased in 29 (12.23%) patients of the Group 2 (severe and critical AP) and was >2.0 ng/ml. Among them in 25 (86.2%) patients early surgical treatment was perfomed and septic inflammation was detected in operating room. Typical ultrasound signs of AP were in 207 (87.34%) patients. Correlation roots between amylase and diastase on the first day of illness were: r=0,71 in the Group 1 and r=0.73 in the Group 2. Conclusions. The diagnosis of AP should be based on a comparative evaluation of the results of instrumental, laboratory tests and clinical symptoms. Levels of PCT, amylase, blood glucose, and urine diastase together with other clinical parameters helped to confirm the diagnosis of AP on admission to the hospital in 162 (92.57%) and 54 (87.09%) patients of the Group 1 and the Group 2. PCT should be used to predict complications and evaluate the efficiency of antibacterial therapy. The study was performed in accordance with the principles of the Declaration of Helsinki. The study protocol was approved by the Local Ethics Committee for all participants. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.