Acute surgical pancreatitis can develop after operations performed on the organs of the digestive system. Most often, postoperative pancreatitis occurs during gastrectomy, removal of the gallbladder and interventions performed on the duodenum.
It is believed that the main cause of the development of this disease is insufficiency or, on the contrary, an overabundance of enzymes produced by the gland and intended for digestive processes.
The cause of such a violation( enzymopathy) is the local pathology of the gland tissues caused by its squeezing or other trauma during the course of the operation. Inflammatory process and the development of postoperative acute pancreatitis is a peculiar response of the gland to such a "rough" effect on its tissues.
Conditionally postoperative pancreatitis is divided into traumatic and non-traumatic. However, there are no clear boundaries between them. Traumatic is postoperative pancreatitis, caused by a direct coarse exposure to the gland tissue, which led to their destruction. Non-traumatic pancreatitis can be triggered by an implicit mechanical effect, for example, when applying forceps, using tampons or surgical mirrors.
It is believed that in the postoperative period acute pancreatitis develops only if the pancreas was previously not healthy or the operation is performed directly on its tissues. The healthy gland is not susceptible to complications of this kind and does not respond to a slight mechanical effect on its tissues during surgical intervention.
The first signs of acute postoperative pancreatitis appear in the period from the second to the fifth day after the surgical intervention. In this case, patients complain of acute pain in the upper abdomen, vomiting with an admixture of bile and constant nausea. The picture of the disease can be lubricated because of taking pain medications during the postoperative period.
The observed abdominal distension, as well as stool retention, can help in setting the correct diagnosis. The condition of the patient is characterized as extremely difficult. It is important to timely diagnose and begin intensive therapy. For this, in the postoperative period, the patient's condition must be constantly and carefully monitored.
For the treatment of patients with postoperative pancreatitis conservative tactics are used, since high complications of resection of the gastrointestinal tract are observed. All measures should be aimed at inactivation of enzymes, elimination of secretory activity. Treatment of postoperative pancreatitis is aimed at suppressing the secretory activity of the organ, eliminating violations of water electrolyte balance. It is also important to carry out a number of preventive measures aimed at combating shock, preventing kidney failure and restoring the cardiovascular system. Antibacterial, anti-allergic and antihistamine therapy is prescribed.
To eliminate pain symptoms, bilateral paranephalic blockade is introduced, plasma transfusion is performed, antibiotics are applied to avoid secondary infection.
When treating postoperative pancreatitis, it is prohibited to eat food and any liquid for 3-5 days. The patient is given parenteral nutrition. To aspirate the gastric juice injected nasogastric tube. A number of measures are being taken to combat enzyme toxemia. It is extremely important to start injecting enzyme inhibitors in a timely manner. The intravenous dropper is placed and the cold on the epigastric region.