[Have changes in the management of treatment of the patients with acute pancreatitis brought the expected result?].

BACKGROUND

Mortality from severe acute pancreatitis (AP) has remarkably decreased (10-20%) during the last decades. However, many questions on the treatment of this disease remained opened. To extend the most recent professional literature which discuses the abovementioned problem, experience from the treatment of patients at the department where the authors work is presented.

METHODS

Influenced by the new methods published in professional literature and under the circumstances at own workplace, the decision to change the management of the treatment of AP has been made. The management referred to the enteral nutrition, epidural analgesy, antibiotic prophylaxis, pushing the surgical operation to the later period in the case of infected necrosis. Comparing of two groups of patients--A (2003-2005 years) and B (2006-2008 years) the authors came to interesting results.

RESULTS

Applying the new protocol we observed: increased percentage of patients with sterile necrosis from 46% to 58%, decreased number of surgical re-operations from 43% to 33% and decreased mortality from 53,8% to 18%.

CONCLUSIONS

Applying changes in the management of treatment of the patients with the complicated form of acute pancreatitis, the authors achieved remarkable results. Nevertheless, these results have to be evaluated very cautiously, because the group of patients who have been treated by the novel approach has not been very large.