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

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.

Инфицированный панкреонекроз, летучие жирные кислоты, гемодиафильтрация