ABSTRACT
The purpose of the study was to evaluate the informative value of volatile fatty acid (VFA) indicators for the differential diagnosis of infected pancreatic necrosis (IPN), complicated by retroperitoneal cellulose phlegmons and IPN, complicated by pancreatic abscesses. The work is based on the results of the examination and treatment of 52 patients with IPN, complicated by abscesses and phlegmon. The analysis of the concentrations of acetic, propionic, butyric and isovaleric acids were carried out on the gas chromatograph "Crystalllux-4000" with the capillary "HP-FFAP" column. Indicators of acetic, propionic, butyric acids and the amount of VFA were statistically significantly higher in patients with IPN, complicated by retroperitoneal cellulose phlegmons, compared with those of VFA in patients with IPN, complicated by pancreatic abscesses. Indicators of acetic acid and the amount of VFA were statistically significantly higher in patients with IPN, complicated by parapancreatic phlegmon, compared with those of VFA in patients with IPN, complicated by pancreatic abscesses. Indicators of acetic, propionic, butyric, isovaleric acid and the amount of VFA were statistically significantly higher in patients with IPN, complicated by paracolic phlegmon, compared with atients with IPN, complicated by pancreatic abscesses. Indicators of acetic, propionic, butyric acids and the amount of VFA were statistically significantly higher in patients with IPN, complicated by total retroperitoneal phlegmon, compared with patients with IPN, complicated by pancreatic abscesses. The values of VFA can be used as additional criteria for the differential diagnosis between IPN, complicated by retroperitoneal phlegmon and IPN, complicated by pancreatic abscess.
Subject(s)
Fatty Acids, Volatile/analysis , Pancreatic Diseases/diagnosis , Acetic Acid , Butyrates , Chromatography, Gas , Diagnosis, Differential , Humans , NecrosisABSTRACT
AIM: To define the role of volatile fatty acids, citrulline and malondialdehyde for diagnosis of suppurative cholangitis in obstructive jaundice and to define optimal surgical approach. MATERIAL AND METHODS: We studied the results of examination and treatment of 87 patients with different hepatopancreatobiliary pathology complicated by obstructive jaundice. It was determined blood concentration and range of volatile fatty acids which are metabolites of facultative anaerobic and obligate anaerobic bacterial pathogens. RESULTS: In 39 patients the defined levels of acetic, propionic, butyric and isovaleric acids contributed to accurate diagnosis of suppurative cholangitis. Statistically significant threshold concentrations of volatile fatty acids were revealed. These values facilitate detection of anaerobic microflora in suppurative cholangitis. CONCLUSION: Research of contents of volatile fatty acids, citrulline and malondialdehyde contributes to early diagnosis of suppurative cholangitis in patients with obstructive jaundice and further objectifies an algorithm of surgical tactics.
Subject(s)
Bacteria, Anaerobic/metabolism , Cholangitis , Citrulline/analysis , Fatty Acids, Volatile/analysis , Jaundice, Obstructive , Malondialdehyde/analysis , Cholangitis/complications , Cholangitis/diagnosis , Cholangitis/microbiology , Cholangitis/physiopathology , Early Diagnosis , Female , Humans , Jaundice, Obstructive/diagnosis , Jaundice, Obstructive/etiology , Jaundice, Obstructive/surgery , Male , Middle Aged , Patient Selection , Reproducibility of Results , Suppuration/diagnosis , Surgical Procedures, Operative/methodsABSTRACT
It was analyzed the treatment results of 108 patients with pancreonecrosis (PN). Gas-liquid chromatography with definition of blood concentration of volatile fatty acids (VFA) was used additionally for timely diagnostics of infected pancreonecrosis. Volatile fatty acids are toxic metabolites of microorganisms. Statistically significant threshold values of VFA were revealed. These values allow to diagnose timely early phase of PN infection and the nature of the microflora. It was defined changes of VFA depending on the severity of infectious process in pancreas and retroperitoneal fiber.
Subject(s)
Bacteria/metabolism , Chromatography, Gas/methods , Fatty Acids, Volatile , Pancreatitis, Acute Necrotizing , Retroperitoneal Space/microbiology , Adult , Bacteria/classification , Disease Management , Early Diagnosis , Fatty Acids, Volatile/analysis , Fatty Acids, Volatile/metabolism , Female , Humans , Male , Middle Aged , Pancreatitis, Acute Necrotizing/diagnosis , Pancreatitis, Acute Necrotizing/microbiology , Pancreatitis, Acute Necrotizing/physiopathology , Pancreatitis, Acute Necrotizing/therapy , Reproducibility of Results , Retrospective Studies , Russia , Severity of Illness IndexABSTRACT
Methods of surgical treatment of the patients, operated on the reason of chronic pancreatitis, complicated by the obstructive jaundice, were comparatively analyzed. 25 patients received pancreatoduodenal resection, 19 patients had the Bern variant of Beger operation. The quality of life was assessed with the use of MOS-SF-36. The duodenum preserving resection of the head of the pancreas showed better long-term results then pancreatoduodenal resection. Those patients, who received biliodigestive anastomosis as the basic operation, showed no good results at all.
