title: [Risk factors and prevention of postoperative pancreatitis after pancreatectomy].
abstract: OBJECTIVE
  to improve the results of pancreatic resections through decrease of postoperative pancreatitis incidence.
  
  
  METHODS
  It was analyzed 207 patients who underwent pancreatic surgery for pancreatic tumor (n=137) or chronic pancreatitis (n=70). 22 risk factors of postoperative pancreatitis were analyzed in 112 patients retrospectively. In prospective study of 95 patients the efficacy of lornoxicam to prevent postoperative pancreatitis was assessed. 68 parameters of immune state were studied to estimate effect of lornoxicam.
  
  
  RESULTS
  Significant factors were mellow pancreatic parenchyma, tumoral disease, pancreatic duct diameter over 3 mm, pancreatric duct index over 0.2, body mass index over 27 kg/m2. Likelihood of postoperative pancreatitis was 40%, 63%, 74.3% and 88.9% if 2, 3, 4 and 5 factors were combined respectively. Preventive use of lornoxicam reduced significantly incidence of postoperative pancreatitis (p=0.042). Incidence of pancreatic fistula and arrosive bleeding was decreased insignificantly due to small number of observations.
  
  
  CONCLUSIONS
  Assessment of significant risk factors and use of medical prevention are available to decrease likelihood of postoperative pancreatitis.
authors.affiliation: Vishnevsky Institute of Surgery, Ministry of Health of the Russian Federation, Moscow, Russia.
authors.forename: A G
authors.initials: AG
authors.lastname: Kriger
authors.affiliation: Vishnevsky Institute of Surgery, Ministry of Health of the Russian Federation, Moscow, Russia.
authors.forename: E A
authors.initials: EA
authors.lastname: Akhtanin
authors.affiliation: Vishnevsky Institute of Surgery, Ministry of Health of the Russian Federation, Moscow, Russia.
authors.forename: V M
authors.initials: VM
authors.lastname: Zemskov
authors.affiliation: Vishnevsky Institute of Surgery, Ministry of Health of the Russian Federation, Moscow, Russia.
authors.forename: D S
authors.initials: DS
authors.lastname: Gorin
authors.affiliation: Vishnevsky Institute of Surgery, Ministry of Health of the Russian Federation, Moscow, Russia.
authors.forename: A V
authors.initials: AV
authors.lastname: Smirnov
authors.affiliation: Vishnevsky Institute of Surgery, Ministry of Health of the Russian Federation, Moscow, Russia.
authors.forename: S V
authors.initials: SV
authors.lastname: Berelavichus
authors.affiliation: Vishnevsky Institute of Surgery, Ministry of Health of the Russian Federation, Moscow, Russia.
authors.forename: M N
authors.initials: MN
authors.lastname: Kozlova
authors.affiliation: Vishnevsky Institute of Surgery, Ministry of Health of the Russian Federation, Moscow, Russia.
authors.forename: N S
authors.initials: NS
authors.lastname: Shishkina
authors.affiliation: Vishnevsky Institute of Surgery, Ministry of Health of the Russian Federation, Moscow, Russia.
authors.forename: A V
authors.initials: AV
authors.lastname: Glotov
mesh_terms: D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007276:Injections, Intraventricular; D008297:Male; D008875:Middle Aged; D010180:Pancreatectomy / Q000009:adverse effects / Q000379:methods; D010190:Pancreatic Neoplasms / Q000601:surgery*; D010195:Pancreatitis / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D050500:Pancreatitis, Chronic / Q000601:surgery*; D019990:Perioperative Care / Q000379:methods; D010894:Piroxicam / Q000008:administration & dosage / Q000031:analogs & derivatives*; D011183:Postoperative Complications / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D010894:Piroxicam; C059451:lornoxicam