Study of Surgical Complications of Pancreatitis
Journal Title: Journal of Medical Science And clinical Research - Year 2017, Vol 5, Issue 1
Abstract
Aims and Objectives: (1) Study of patients of pancreatitis with respect to their complications requiring surgical intervention. (2) To study prognosis of patients after surgical treatment of complications of pancreatitis. Study Design:- This was a descriptive study carried out in a tertiary care centre over a period of 18 months and included patients of acute and chronic pancreatitis with their surgical complications. Materials and Methods:- The study was approved by the Institutional ethical committee and included patients of acute and chronic pancreatitis with their surgical complications. Patients were included in this study only after being diagnosed as a complication of pancreatitis needing surgical intervention. Informed consent was obtained after explaining all patients regarding disease outcome and possible complications related to surgical treatment. Patients having history of trauma, those who denied consent, those in whom regular follow up was not possible and those who didn't give consent were excluded from the study. Results: The study of surgical complications of pancreatitis revealed that the peak incidence of their occurrence was in between age group of 30 to 39 years (29.54%) followed by in the age group of 40-49 years (15.90%). Predominantly males were affected with a male to female ratio being 1: 0.12. The most common etiology was found to be alcohol (68.18%) followed by idiopathic (15.90%) and malnutrition (11.36%). The most common presenting complaints were pain (90.90%) followed by weight loss (86.36%) and steatorrhoea (43.18%). On clinical examination the most common physical finding was tachycardia (29.54%), icterus (20.45%) and raised temperature (18.18%). Blood investigations most common abnormalities found were anemia, leucocytosis, hyperbillirubinemia, and increased serum lipase levels. On X-ray Pleural effusion and abdominal calcifications was found in 13 (29.54) and 12 (27.27%) patients respectively. The most common surgical complication in studied cases were pseudocyst formation (36.36%), ductal dilatation with without ductal calculi (25%) and pancreaticopleural effusion (15.90%). Uncomplicated pseudocyst (31.81%), pancreatic calcification (27.27%),pancreatic ductal calculi (20.45%), atrophy of pancreas (20.45%) and CBD dilation (20.45%) were the most common imaging abnormalities seen in CT and MRCP. Obstructive jaundice was seen in 9 (20.45%) patients. The most common surgical procedure done in studied cases was intercostal drain insertion for pleural effusion which was done in 7 (15.90%) other common surgical procedures were laparoscopic cystogastrostomy (4.54%), and laparoscopic LPJ (9.09%). Laparoscopic surgeries were done in 16 (36.36%) cases while open surgeries were done in 28 (63.63%) patients. Immediate post-operative complications included wound infection (9.09%), bleeding (4.54%) and anastomotic leak (4.54%). Common late post-operative complications were Deranged blood sugar levels (11.36%), intra-abdominal abcess (6.81%) and weight loss (6.81%). Amongst the patients operated for pancreatic pseudocyst only 1 patient presented with pseudocyst recurrence 6 months after initial surgery. Puestow procedure was most commonly associated with weight gain. All 6 (100%) patients had weight gain after this procedure while necrosectomy was least associated (20%) with weight gain. The most effective procedure in terms of pain relief was puestow procedure in which 6 (85.71%) out of 7 patient had pain relief. The overall mortality in the study was found to be 6.81%.
Authors and Affiliations
Dr Pravin Bhingare
Correlation of Bilirubin Levels in Patients with and Without Cerebrovascular Accident
Stroke is a clinical syndrome of rapid onset of focal cerebral deficit, lasting more than 24 hours or leading to death, with no apparent cause other than a vascular. Bilirubin, a breakdown product of normal heme cataboli...
Clinical Study of Mass in Right iliac Fossa
Aims & Objectives: To study clinical entities presenting as mass in right iliac fossa in relation to incidence, age & sex distribution, clinical presentation, modality of diagnosis, types of management, complications. Ma...
Role of family history and other metabolic factors in Diabetes in Asian Indian population
Introduction: Type 2 diabetes mellitus (T2DM) is a type of metabolic disorder, which is currently imposing a serious threat to the well-being of the world population. Globally, an estimated 422 million adults are living...
The Association of Obesity and Blood Pressure in Children Studying in Schools in a Rural Area
Background: Childhood obesity and hypertension are major problems worldwide. Obesity is the leading cause of hypertension and hence preventing obesity has a good impact on controlling hypertension. Thus it is important t...
Biochemical Parameters in Acute Myocardial Infarction with or Without Co-Morbidities
Acute myocardial infarction is one of the most common cause of death and one of the most frequent causes of hospitalization. Acute Myocardial Infarction occurs when there is an imbalance between supply and demand for oxy...