Role of Volatile Fatty Acids in the Diagnosis and Assessment of Efficiency of Complex Treatment of Infected Pancreonecrosis

Abstract


Relevance Pancreonecrosis remains a challenge due to abdominal surgery increase morbidity and continuing high mortality, primarily from septic complications. To date, timely diagnosis of infected pancreonecrosis often causes problems, and the use of methods of efferent therapy in the postoperative period remains controversial. The purpose of the study By the method of gas liquid chromatography to improve early diagnosis of infected pancreonecrosis and evaluate the effectiveness of continuous veno-venous hemodiafiltration (CVVHDF) in its complex treatment. Materials and methods The results of treatment of 52 patients with infected pancreonecrosis. All patients were additionally determined blood concentration and dynamics of volatile fatty acids (acetic, propionic, butyric and isovaleric) by gas liquid chromatography. 23 patients in the postoperative period was conducted sessions CVVHDF on gemoprotsessor «Prismaflex» (Gambro-Hospal). In the remaining 29 patients, the control group, in the postoperative period CVVHDF not used. Results and their discussion The possibility of the use of volatile fatty acids in the differential diagnosis and evaluation of the effectiveness of complex treatment of infected pancreonecrosis. All 52 patients in the event of infectious complications of pancreonecrosis acetic acid concentration in the blood was more 0,11 mmol/l. This is because the acetic acid is a common metabolite of aerobic and anaerobic flora. In 29 (55.8%) people diagnosed with anaerobic flora found a significant increase in the concentration of propionic, butyric and isovaleric acids. CVVHDF after surgical interventions for septic complications of pancreonecrosis to improve outcomes and reduce mortality from 27,6% to 17,4%. The effectiveness of the method is confirmed by a significant reduction of indicators of volatile fatty acids. Conclusion Performance evaluation of volatile fatty acids is an additional means of diagnosis of infected pancreonecrosis. In complicated forms of infected pancreonecrosis operation, supplemented hemodiafiltration, to improve outcomes and reduce mortality. Dynamic determination of volatile fatty acids in the blood is the criterion of control and effectively apply the tactics.

Ivanovo State Medical Academy, 8 Sheremetevskii Ave., Ivanovo, 153012, Russian Federation

Author for correspondence.
Email: sanata@dsn.ru

Russian Federation MD, PhD, Docent, Prof. of the Faculty Surgery and Urology Chair of the Ivanovo State Medical Academy.

Ivanovo State Medical Academy, 8 Sheremetevskii Ave., Ivanovo, 153012, Russian Federation
Ivanovo Regional Clinical Hospital, 1 Liubimova Str., Ivanovo, 153040, Russian Federation

Email: ivanenkov.im@mail.ru

Russian Federation Surgeon of the Surgical Department for adult patients of the Ivanovo Regional Clinical Hospital; graduate student of the Faculty Surgery and Urology Chair of the Ivanovo State Medical Academy.

Ivanovo State Medical Academy, 8 Sheremetevskii Ave., Ivanovo, 153012, Russian Federation

Email: author@vestnik-surgery.com

Russian Federation - Assistant of the Faculty Surgery and Urology Chair of the Ivanovo State Medical Academy

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