The evaluation of the consequences of changes in diagnostic-therapeutic management in patients with acute pancreatitis in the period 1995-2005

Introduction: The introduction of new surgical technicses and successes in the pathophysiology of the pancreas invited modifications of the therapeutic procedure with patient on acute pancreatitis (AP).

Aim: The evaluate the results of the treatment of AP in two periods 1995-2000 and 2000-2005 and long-term conse-quences in 50 patient with a history of AP.

Material and methods: The study involved 422 patients with AP treated in the Surgery Department of the Hospital in Konskie. Diagnosis was based on clinical symptoms, research laboratory- and imaging techniques. Fifty patients after AP one exposed to the investigation follow up.

Results: Surgical interventions in the analyzed periods included, respectively: conventional surgeries 40 (22%) and 24 (10%), ERCP in group I 1 (0.5%), in group II 28 (12%). The percentage of surgical interventions between 1995 and 2000 was considerably higher (p = 0.0011) than between 2000 and 2005. The author’s own research carried out on 50 patients after glucose tolerance tests, demonstrated normal blood glucose levels (NGT) in 13 patients (26%), diabetes in 12 patients (24%), and glucose intolerance (IGT) in 22 patients (44%). Ultrasound scaning demonstrated normal pancreas sonographic images in 14 patients (18%), and minor, moderate and severe lesions in 22 (44%), 8 (16%), and 6 (12%) patients with AP respectively.

Conclusions: Changes in treatment procedures concerning AP resulted in reduced number of unnecessary laparotomy procedures increased number of ERCP in acute biliary pancreatitis. The overall changes in diagnostic and treatment procedures had no influence on complications or statistical mortality rates in acute pancreatitis. Acute pancreatitis impairs normal carbohydrate metabolism in a considerable percentage of patients, which is not reflected in the pancreas morphology image.