Quality of life following acute necrotizing pancreatitis.

BACKGROUND/AIMS: The authors examine the quality of life of patients treated for acute necrotizing pancreatitis an average of 37.8 months following their illness. METHODOLOGY: The questionnaire used in the examinations was a version of the Short Form-36 (SF-36) which was adapted to a Hungarian environment and included additional questions regarding the patient's illness. During the treatment of the pancreatic necrosis, prophylactic antibiotic treatment, early nasojejunal feeding, percutaneous peripancreatic drainage, and late surgical necrectomy was used. Postoperatively the lavage of the closed omental bursa was performed. RESULTS: It was determined that 77.3% of patients considered their quality of life to be good or fair. Quality of life was considered worse in older patients, patients with complaints of abdominal distension and bowel problems, patients who had lost significant amounts of weight since their illness, patients with poor appetite, and patients who were female. CONCLUSIONS: The long-term result, and the quality of life after acute necrotizing pancreatitis is good.

CT-guided percutaneous peripancreatic drainage: a possible therapy in acute necrotizing pancreatitis.

BACKGROUND/AIMS: To examine the effectiveness of therapeutic percutaneous drainage of peripancreatic fluid in the treatment of acute necrotizing pancreatitis. METHODOLOGY: Twenty-eight patients treated for serious acute necrotizing pancreatitis (19 male, 9 female; average age 47.3 years) took part in the study. The cause of acute necrotizing pancreatitis was alcohol abuse in 20 of the cases, gallstone disease in 7 cases, endoscopic retrograde cholangiopancreatography in 2 cases, trauma in one case, and 4 of the cases had unknown cause. In all cases preventative antibiotics were given as part of intensive therapy, early nasojejunal nutrition was used, and we endeavored to avoid surgery or to delay it depending on the case. The acute peripancreatic fluid was drained percutaneously. In total, percutaneous drainage was used in 12 patients. RESULTS: Of the 28 patients, only 3 patients recovered solely with conservative therapy, without drainage. Three patients recovered using only percutaneous drainage without surgery. In 9 patients surgery was necessary after percutaneous drainage was performed. In the remaining 13 patients, only surgical treatment was used, without percutaneous drainage. In total 20 reoperations were done in 10 patients. Of the 12 patients treated with percutaneous drainage, one patient died. The total mortality was 14.3%. CONCLUSIONS: In certain cases the percutaneous drainage of the acute peripancreatic fluid that collects in acute necrotizing pancreatitis is sufficient for the total recovery of acute necrotizing pancreatitis, in other cases can be used to postpone surgery.

[The role of D2 lymphadenectomy in the surgical treatment of gastric carcinoma]. / A D2 lymphadenectomia szerepe a gyomorkarcinóma sebészi kezelésében.

The authors examine 145 patients with gastric carcinoma who underwent curative resection with additional D2 lymphadenectomy at the 2nd Surgical Department of DUMHSC between January 1, 1996 and December 31, 2000. Subtotal resection was performed in 103 patients, and total, gastrectomy was performed in 42 patients. Postoperative mortality was 5.5% and disease-related complications occurred in 17.9%. The three-year survival was 49.7%, while in patients with "early" (maximum infiltration to the level of the submucosa) gastric carcinoma 3-year survival rate of was 86.3%. The results correlate with the data in the literature, so the use of D2 lymphadenectomy in the surgical treatment of gastric carcinoma is strongly advised.