ABSTRACT
In the present paper, we evaluate the possible reduction in the rate of relapses in acute biliary pancreatitis through treatment with ursodeoxycholic acid (UCA), between the episode of pancreatitis and the moment of cholecystectomy. We studied 72 consecutive first episodes of acute biliary pancreatitis, in patients who had not yet undergone colecistectomy, followed up until surgery. The cases were divided into group A (n=30), treated with ursodeoxycholic acid 10 mg/kg/day, until surgery, and group B or control (n=42). We evaluated the differences between both groups, regarding patient characteristics, pancreatitis severity, characteristics of the lithiasis and delay until surgery. We analysed pancreatitis relapses in both groups, with and without UCA. In the UCA group we compared the duration of treatment between patients with and without pancreatitis relapse. The two groups did not show significant differences regarding any of the studied parameters. We registered 7/30 (23.3%) relapses in UCA group, versus 9/42 (21.4%) relapses in the control group (p = 0.85). In UCA group, treatment duration was similar between relapsed cases: 4.9+/-4.5 months and those without relapse: 4.4+/-1.9 months (p = 0.78). In our experience, the use of UCA until the moment of cholecystectomy does not reduce relapse incidence in patients following the first episode of acute biliary pancreatitis. UCA treatment duration did not seem to be related with the occurrence of pancreatitis relapse.
Subject(s)
Cholagogues and Choleretics/therapeutic use , Pancreatitis/drug therapy , Ursodeoxycholic Acid/therapeutic use , Acute Disease , Aged , Cholecystectomy/methods , Cholelithiasis/complications , Cholelithiasis/diagnosis , Cholelithiasis/therapy , Female , Humans , Male , Middle Aged , Pancreatitis/diagnosis , Pancreatitis/etiology , Preoperative Care , Secondary Prevention , Treatment OutcomeABSTRACT
En el presente trabajo se ha valorado la posible reducción de la tasa de recidivas en la pancreatitis aguda biliar mediante el tratamiento con ácido ursodeoxicólico (AUC) entre el episodio de pancreatitis y el momento de la colecistectomía. Se estudiaron 72 primeros episodios consecutivos de pancreatitis aguda biliar, en pacientes no colecistectomizados, seguidos hasta la cirugía. Los casos se dividieron en grupo A (n = 30), tratados al alta con AUC 10 mg/kg/día, hasta la cirugía, y grupo B o control (n = 42). Se evaluaron las diferencias entre ambos grupos en cuanto a características del paciente, gravedad de la pancreatitis, características de la litiasis y demora hasta la cirugía. Analizamos las recidivas de la pancreatitis entre los grupos con y sin AUC. En el grupo con AUC comparamos la duración del tratamiento entre los pacientes con y sin recidiva de la pancreatitis. Los dos grupos no mostraron diferencias significativas en cuanto a ninguno de los parámetros estudiados. Registramos 7/30 (23,3 por ciento) recidivas en el grupo AUC, frente a 9/42 (21,4 por ciento) recidivas en el control (p = 0,85). Dentro del grupo AUC, la duración del tratamiento fue similar entre los casos que recidivaron: 4,9ñ4,5 meses y los no recidivados: 4,4ñ1,9 meses (p = 0,78).En nuestra experiencia, el empleo de AUC hasta el momento de la colecistectomía no reduce la incidencia de recidiva en los pacientes tras un primer episodio de pancreatitis aguda biliar. La duración del tratamiento con AUC tampoco parece relacionarse con la aparición o no de recidivas (AU)
Subject(s)
Female , Male , Humans , Pancreatitis/surgery , Preoperative Care/methods , Ursodeoxycholic Acid/administration & dosage , Recurrence/prevention & control , Cholelithiasis/complications , Pancreatitis/complications , Treatment OutcomeABSTRACT
We review the incidence of iatrogenic complications in a serie of 661 patients who underwent endoscopic polypectomy, performed by the same team of endoscopists and using similar technique. We discuss the role of age, sex, associated diseases, coagulation abnormalities and polyp features (size, location, shape and malignancy) in the development of complications. Five severe complications (0.75%, 3 hemorrhages and 2 perforations) were detected. Two patients required blood transfusion and two other patients surgical treatment. Recovery was successful in all patients. In eight patients (1.21%) mild complications which did not required further treatment were present. According to previously published data, these results are satisfactory. Polyp size proved to be the only risk factor with statistical significance; 23.36 +/- 14.17 mm. in complicated polypectomies vs 8.12 +/- 4.21 mm. in non-complicated cases (p less than 0.001). The remaining parameters analyzed showed no significance and therefore no predictive value.
