Routine laboratory parameters in patients with necrotizing pancreatitis by the time of operative pancreatic debridement:Food for thought  

作　　者：Yaroslav M Susak Kristina Opalchuk Olexandr Tkachenko Mariia Rudyk Larysa Skivka 

机构地区：[1]Department of Surgery with the Course of Emergency and Vascular Surgery,O.O.Bogomolet’s National Medical University,Kyiv 01601,Ukraine [2]Department of Surgery,Anesthesiology and Intensive Care Postgraduate Education,O.O.Bogomolet’s National Medical University,Kyiv 01601,Ukraine [3]Department of Surgery N2,Kyiv City Clinical Emergency Hospital,Kyiv City Clinical Emergency Hospital,Kyiv 02000,Ukraine [4]Department of Microbiology and Immunology,Educational and Scientific Center“Institute of Biology and Medicine”,Taras Shevchenko National University of Kyiv,Kyiv 01033,Ukraine

出　　处：《World Journal of Gastrointestinal Surgery》2022年第1期64-77,共14页世界胃肠外科杂志（英文版）（电子版）

摘　　要：BACKGROUND Timing of invasive intervention such as operative pancreatic debridement(OPD)in patients with acute necrotizing pancreatitis(ANP)is linked to the degree of encapsulation in necrotic collections and controlled inflammation.Additional markers of these processes might assist decision-making on the timing of surgical intervention.In our opinion,it is logical to search for such markers among routine laboratory parameters traditionally used in ANP patients,considering simplicity and cost-efficacy of routine laboratory methodologies.AIM To evaluate laboratory variables in ANP patients in the preoperative period for the purpose of their use in the timing of surgery.METHODS A retrospective analysis of routine laboratory parameters in 53 ANP patients undergoing OPD between 2017 and 2020 was performed.Dynamic changes of routine hematological and biochemical indices were examined in the preoperative period.Patients were divided into survivors and non-survivors.Survivors were divided into subgroups with short and long post-surgery length of stay(LOS)in hospital.Correlation analysis was used to evaluate association of laboratory variables with LOS.Logistic regression was used to assess risk factors for patient mortality.RESULTS Seven patients(15%)with severe acute pancreatitis(SAP)and 46 patients(85%)with moderately SAP(MSAP)were included in the study.Median age of participants was 43.2 years;33(62.3%)were male.Pancreatitis etiology included biliary(15%),alcohol(80%),and idiopathic/other(5%).Median time from diagnosis to OPD was≥4 wk.Median postoperative LOS was at the average of 53 d.Mortality was 19%.Progressive increase of platelet count in preoperative period was associated with shortened LOS.Increased aspartate aminotransferase and direct bilirubin(DB)levels the day before the OPD along with weak progressive decrease of DB in preoperative period were reliable predictors for ANP patient mortality.CONCLUSION Multifactorial analysis of dynamic changes of routine laboratory variables can be useful for a person-ta

关 键 词：Acute necrotizing pancreatitis Operative pancreatic debridement timing Dynamic changes of laboratory variables Preoperative period Necrotic tissue encapsulation Hospital length of stay 

分 类 号：R657.51[医药卫生—外科学]