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Query: UMLS:C0030305 (pancreatitis)
 16,014 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Continuous epidural anesthesia was used in a 34 year-old pregnant woman with acute pancreatitis related to hypertriglyceridemia. She underwent an emergency cesarean section due to severe pancreatitis under spinal anesthesia. After delivery, extended incision was made to examine the pancreas and to perform drainage. Epidural infusion using 1% mepivacaine and buprenorphine was started to reduce pain and improve microcirculation. After starting epidural infusion with other therapies, clinical feature and data improved. This case suggests that reduction of severe pain and improvement of microcirculation are important in therapies of severe pancreatitis.
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PMID:[Anesthetic management in a patient with severe acute pancreatitis during pregnancy]. 1068 43

A 61 year old male patient developed postoperative pancreatitis after total hip replacement under general anesthesia with sevoflurane. The patient had chronic renal failure and was receiving hemodialysis. The estimated intraoperative blood loss was 1500 ml, and 1200 ml of blood was administered. The intraoperative mean blood pressure was 60 to 70 mmHg and the central venous pressure at the end of anesthesia was 0 mmHg. Postoperatively he complained of severe upper abdominal pain. On the 1st postoperative day serum amylase level increased to fifteen times of the normal level. He complained again of severe abdominal pain on hemodialysis. From these episodes, we estimate that the circulatory disturbance of pancreas is the cause of this postoperative pancreatitis.
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PMID:[Postoperative pancreatitis after total hip replacement under general anesthesia]. 1075 29

A 56-year-old female, who had been suffering from heart failure and diabetes mellitus, underwent posterior instrumentation in the prone position and anterior interbody fusion in the right lateral decubitus position for pyogenic spondylitis between the fourth and fifth lumbar spine under general and epidural anesthesia. We induced hypotensive anesthesia by using continuous infusion of dopamine, prostaglandin E1 and nitroglycerin in order to prevent heart failure and reduce the blood loss. After the operation, the patient complained of upper abdominal pain, nausea and vomiting. We found high levels of serum amylase and other pancreatic enzymes. The massive gas of small intestine was pooled in abdominal X-P, and the pancreatic head was slightly swollen in abdominal CT and US. Therefore we came to the diagnosis of postoperative acute pancreatitis. We administered a single bolus intravenous infusion of ulinastatine and continuous venous infusion of gabexate mesilate. As the serum amylase level gradually decreased, the patient improved. We suspect that postoperative pancreatitis was due to invasive anesthetic and surgical stress on the patient who had had pancreatitis in the preoperative period.
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PMID:[A case of acute pancreatitis that occurred after an operation of the lumbar spine]. 1088 49

Fast magnetic resonance (MR) imaging of the rat pancreas was carried out using a snapshot method to observe three-dimensional (3D) and temporal development of the pancreatic cyst after experimental pancreatitis. Acute pancreatitis was induced by a retrograde infusion of the trypsin-taurocholate solution into the pancreatic duct in 23 rats, of which seven survived for one month. Under 2% enflurane anesthesia, (1)H images of the rat abdomen were taken by a 4.7 T magnetic resonance spectrometer under spontaneous breathing. 3D images of the pancreas and cyst were reconstructed from the axial, sagittal and coronal images taken before, 24 h, 7 days, 14 days, 21 days and 28 days after the induction of pancreatitis. The 3D images reconstructed from different slice orientations at each time point showed good agreement with each other. The calculated volumes of the cyst on 7th, 14th, 21st, and 28th day were 0.3 +/- 0.1, 0.8 +/- 0.3, 2.1 +/- 0.6, 6.5 +/- 1.3 mL, respectively. The cystic fluid volume on 28th day was 6.4 +/- 1.4 mL, which confirmed reliability of volume measurement by MR imaging. Fast MR imaging (snapshot) together with 3D reconstruction allows us to understand the detailed chronological and spatial development of pancreatic cyst after acute pancreatitis in rats.
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PMID:Time-course magnetic resonance imaging of rat pancreatic cyst after experimental pancreatitis. 1112 5

Laparoscopic treatment of ductal calculi in experienced hands is more successful and incurs a shorter hospital stay and overall costs than current orthodox two-stage management (endoscopic stone extraction followed by cholecystectomy). The results of large series of laparoscopic ductal stone clearance report a median success rate of 90%, a mortality under 1%, and a missed stone rate of 0.8% to 4%. Thus the case for routine preoperative endoscopic stone extraction is no longer sustainable and this management option should be reserved for patients with cholangitis, severe gallstone-associated pancreatitis, and for patients considered unfit for surgery and general anesthesia. The remaining issues concern standardization of the techniques of laparoscopic ductal stone extraction and the intraoperative management algorithm with agreed indications for transcystic extraction versus direct common bile duct (CBD) exploration. Narrowed bile ducts should not be explored directly, and if the transcystic laparoscopic approach fails in these cases, endoscopic extraction is the safest option, either at the time of surgery under the same anesthetic or during the postoperative period. The insertion of a T-tube after direct common duct exploration detracts considerably from the benefits of the laparoscopic approach, and primary closure with either a cystic duct drainage cannula or by means of a temporary endobiliary stent is recommended.
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PMID:Ductal stones: pathology, clinical manifestations, laparoscopic extraction techniques, and complications. 1132 62

The postoperative pancreatitis is a well-known complication. More than eighty-five drugs have been reported to have induced postoperative pancreatitis. Twenty-five cases of Propofol-induced pancreatitis have been reported till now. The relation of pancreatitis to Propofol (Diprivan; Zeneca; London, UK) is considered as a possible one, but has been proved. The goal of the authors is to reveal the plasma lipid and amylase level dynamics in patients after Propofol anaesthesia. The clinicians have to consider this possible relation, because of the growing use of Propofol recently.
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PMID:[Risk of drug-induced acute pancreatitis following propofol anesthesia used in abdominal operations]. 1148 59

Endoscopic retrograde cholangiopancreatography and endoscopic sphincterotomy are carried out for a variety of billo-pancreatic diseases. These procedures were earlier performed at only a handful of tertiary centres in India. However, of late, they are being performed at several centres and even smaller clinics. Although, endoscopic sphincterotomy is one of the most commonly performed endoscopic procedure, there are no data on the number of procedures performed each year in India. It is estimated that in the USA alone more than 200,000 procedures are performed each year. The procedure has the dubious distinction of being considered as one of the most hazardous of all endoscopic procedures and is associated with a small but significant morbidity and mortality. The immediate complications of endoscopic sphincterotomy include pancreatitis, haemorrhage, perforation and cholangitis in addition to those associated with the use of sedation and anaesthesia. There are also reports of the long term adverse effects of the destruction of the sphincter of Oddi. There is also controversy as to what should be the minimum requirements for training and who should be allowed to perform these procedures.
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PMID:Complications of endoscopic retrograde cholangiopancreatography and endoscopic sphincterotomy: diagnosis, management and prevention. 1185 89

According to a previous study, an excellent level of analgesia can be expected when using epidural anaesthesia in patients with acute pancreatitis. In the present investigation, the effectiveness and safety of epidural anaesthesia is demonstrated in a large group of patients with severe acute pancreatitis, who were admitted to an intensive care unit. Epidural anaesthesia alone produced excellent analgesia on 1,083 of 1,496 observation days (72%) without the systemic use of other analgesic substances. Even in patients with marginal cardiovascular stability, epidural injection of local anaesthetic solution was tolerated well. Only 8% of all local anaesthetic injections were associated with a haemodynamic reaction that required pharmacological intervention. There was no case of a septic or neurological complication of epidural anaesthesia. Initially elevated serum amylase and lipase were normalized after 17.4 days (minimum one day, maximum 19 days). Surgical intervention was necessary for 36 patients, with a total of 64 surgeries having to be performed, including cholecystectomy. Sixteen patients required artificial ventilation for an average time of 12.3 days (minimum two days, maximum 48 days). Lethality was 2.5% (three patients), with all three patients suffering from an acute stage III pancreatitis. The average duration of ICU treatment was 12.4 days (minimum two days, maximum 101 days).
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PMID:[Using epidural anesthesia in patients with acute pancreatitis--prospective study of 121 patients]. 1190 96

A 35-year-old man developed two episodes of postoperative pancreatitis. The first one occurred after knee surgery and the second one 6 years after surgery for excision of haemorrhoids. Induction of anaesthesia associated propofol 200 mg and sufentanil 15 microg. Anaesthesia was maintained with sevoflurane administered through a laryngeal mask. The possible association between the drugs used during anaesthesia and the postoperative pancreatitis is discussed.
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PMID:[Postoperative pancreatitis after non abdominal surgery]. 1452 93

The modern technique of postoperative analgesia after extensive and traumatic surgical interventions presupposes the administration, apart from opiates, a variety of preparations inhibiting the biological activity of substances (prostaglandins, kinins, TNF, leukotrienes, etc.), i.e. mediators of the systemic-inflammatory response, which are of the key importance in modeling the postoperative pain. The paper deals with the specificity of postoperative analgesia at different stages of surgical treatment of patients with destructive pancreatitis (DP). The surgical tactics in DP envisages a primary revision of the abdominal cavity, necrectomy and omentobursostomy with subsequent multi ple stage-based sanations of the abdominal cavity. The above surgical technique in DP is traumatic and long-lasting with the in-hospital treatment amounting on the average to 46.8 +/- 3.2 days. The entire postoperative period in DP patients is divided into 4 stages with each stage having a certain specific level of intoxication, systemic-inflammatory response and of pain syndrome. An analgesia scheme, based on epidural anesthesia combined with the inhibitors of kinin-genesis (inhitril, contrical) of prostaglandin-genesis (ketorol of xefocam) and of a synthetic analogue of leu-enkephalines (daralgin). A specific combination of analgetics was typical of each treatment stage.
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PMID:[Selection of components and methods for postoperative analgesia after extensive abdominal surgeries]. 1467 12


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