Xiong Ding1, Chang-An Liu, Jian-Ping Gong, Sheng-Wei Li. 1. Department of Hepatobiliary Surgery, Second Clinical College, Chongqing University of Medical Sciences, Chongqing 400010, China. dingpanda@163.com
Abstract
BACKGROUND: Pancreatic encephalopathy (PE), an unfamiliar complication of severe acute pancreatitis (SAP), is difficult to diagnose and treat, and it has a high mortality. The aim of this study was to investigate the manifestation, classification, mechanism and therapy of PE. METHODS: Of 132 patients with SAP treated at our hospital from March 1994 to March 2004, 24 patients complicated by PE were analyzed retrospectively. RESULTS: The causes of SAP were mostly biliary and alcoholic. Twenty-four patients (18.2%) were complicated by PE within 3 hours-38 days(average 6.6 days)[21(87.5%) within 2 weeks, and 3(12.5%) after 2 weeks] . Eleven patients were male and 13 female, with an average of 47 years (range 25-72 years). Excitement or restrain was the main manifestation. Nine patients (37.5%) received surgery and 15(62.5%) conservative treatment, with a mortality of 11.1%(1/9) and 66.7%(10/15), respectively. CONCLUSIONS: PE occurs 2 weeks after SAP and is part of multiple organ failure (MOF). Some patients have PE in the late stage of SAP because of lack of VitB1 and nutrition. But PE can be prevented by prescribing adequate nutrition and VitB1 in the early stage of SAP.
BACKGROUND:Pancreatic encephalopathy (PE), an unfamiliar complication of severe acute pancreatitis (SAP), is difficult to diagnose and treat, and it has a high mortality. The aim of this study was to investigate the manifestation, classification, mechanism and therapy of PE. METHODS: Of 132 patients with SAP treated at our hospital from March 1994 to March 2004, 24 patients complicated by PE were analyzed retrospectively. RESULTS: The causes of SAP were mostly biliary and alcoholic. Twenty-four patients (18.2%) were complicated by PE within 3 hours-38 days(average 6.6 days)[21(87.5%) within 2 weeks, and 3(12.5%) after 2 weeks] . Eleven patients were male and 13 female, with an average of 47 years (range 25-72 years). Excitement or restrain was the main manifestation. Nine patients (37.5%) received surgery and 15(62.5%) conservative treatment, with a mortality of 11.1%(1/9) and 66.7%(10/15), respectively. CONCLUSIONS: PE occurs 2 weeks after SAP and is part of multiple organ failure (MOF). Some patients have PE in the late stage of SAP because of lack of VitB1 and nutrition. But PE can be prevented by prescribing adequate nutrition and VitB1 in the early stage of SAP.