Influence of Jaundice Nature on the Treatment Tactics of Patients With Acute Pancreatitis

Abstract

Abstract. The aim of the study is to improve the treatment results of patients with AP with jaundice syndrome by improving the quality of differential diagnosis of the nature of concomitant jaundice.
 Materials and methods of research. The treatment results of 52 patients with acute pancreatitis complicated by jaundice syndrome were analyzed, jaundice was mechanical in 42 (80.9 %) cases, parenchy-mal – in 10 (19.1 %).
 Results and discussion. 28 from 42 patients with acute pancreatitis and mechanical jaundice caused by concretion in the large duodenal papilla, choledocholithiasis and papillitis underwent endoscopic papillosphincterotomy with nasobiliary drainage. In 7 cases open cholecystectomy with choledocholithotomy and retroduodenal space drainage were performed due to the large size of concretions. LChE was performed in 21 case, elective laparoscopic cholecystectomy was performed in 14 patients with compression of the common hepatic duct by inflammatory infiltrate in the gallbladder neck. There were no fatalities in the group of patients with acute pancreatitis and mechanical jaundice. In the group of patients with acute pancreatitis and parenchymal jaundice 4 from 10 patients died, mortality was 40 %.
 Conclusions. Ultrasound is required for differential diagnosis of mechanical and parenchymal jaundice in acute pancreatitis, which allows the determination of the treatment tactics, type of surgery and the extent of conservative therapy.