[Our experience on the effect of complex treatment with gordox in patients with acute and chronic-recurrent pancreatitis].
OBJECTIVE
In this retrospective trial we assess how acute pancreatitis patients respond to nonoperative therapy; operative methods and results after surgery for acute and chronic-recurrent pancreatitis.


METHODS
We present 738 acute pancreatitis patients, treated from 1991 to 2001 in our clinic. In all cases we start a nonoperative therapy comprising losses replacement, analgesics (including narcotic ones), spasmolytics, antibiotics, protease inhibitors-Contrical or Gordox (only during 1997 and 1998) and/or somatostatine (Sandostatin), H2-blockers, naso-gastric tube. Monitoring of the main parameters as blood pressure and pulse rate, number of leukocytes, values of serum amylase, urea and creatinine is performed.


RESULTS
576 responded to this therapy and recovered. The ones who worsened--162 acute pancreatitis patients--underwent surgery: necrectomy followed by postoperative prolonged local lavage in the area of pancreatic couch or laparostomy. This method contributes to a prolonged evacuation of biologically active substances and devitalized tissues. The average number of Ranson's Prognostic Criteria was 4.5. Furthermore, mortality is reduced to 19%. A mortality analysis is done. Surgery (cholecystectomy and bile duct exploration) is offered to patients who recovered from acute pancreatitis caused by cholelythiasis and/or choledocholythiasis.


CONCLUSIONS
The majority of patients respond to the nonoperative therapy. Despite the recent improvement in diagnostics and treatment of acute pancreatitis morbidity and mortality rates are still high.
Iarumov
N
N
Ognianov
S
S
Gachev
H
H
Vasilev
H
H
Stefanov
B
B
Evtimov
R
R
D000208:Acute Disease; D007611:Aprotinin / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000188:drug therapy* / Q000401:mortality; D011379:Prognosis; D012008:Recurrence; D012189:Retrospective Studies; D016019:Survival Analysis; D014361:Trypsin Inhibitors / Q000627:therapeutic use*
D014361:Trypsin Inhibitors; C011475:gordox; D007611:Aprotinin