Year 2021 Vol. 29 No 5

GENERAL & SPECIAL SURGERY

I.V. KOLOSOVYCH, I.V. HANOL

PURULENT SEPTIC COMPLICATIONS OF ACUTE PANCREATITIS AND THEIR PATHOGENETIC RELATIONSHIP WITH HELICOBACTER PYLORI

A.A. Bogomolets National Medical University, Kiev,
Ukraine

Objective. To study of the role of Helicobacter pylori as an etiological factor of acute pancreatitis and a marker of the development of its purulent-septic complications.
ethods. The study was conducted in the period of 2015-2020; patients with acute pancreatitis (n=124) were divided into 2 groups: the main group (66 patients with moderate severity and severe course) and the comparison group (58 patients with a mild form). All patients underwent a screening study of Helicobacter pylori in feces and serological blood test to detect antibodies, namely immunoglobulin M to Helicobacter pylori (determination of the phase of the disease acute or chronic). In 39 (31.5%) patients of the main group, a bacteriological study of biological and biopsy specimens of antral mucous membrane were taken and examined histologically for organisms.
The selection of antibiotics for treatment was carried out taking into account the infection of patients with Helicobacter pylori and was performed using the authors method, the effectiveness of treatment was controlled microbiologically.
Results. The positive result of the express test was in 66 (100%) patients of the main group and in 39 (67.2%) patients in the comparison group. During serological examination, a positive result was obtained: 24 hours after hospitalization in 8 (13.8%) patients in the comparison group, in 23 (34.8%) patients in the main group; after 7 days in 9 (15.5%) patients and 42 (63.3%) patients, respectively. Helicobacter pylori is sensitive to the majority of antibiotics used to treat purulent-septic complications of acute pancreatitis; after finishing the course of antibiotic therapy, eradication was achieved in 37 (94.9%) patients of the main group.
Conclusion. Positive results of a serological study of elicobacter pylori after 7 days from the moment of hospitalization were more common in patients of the main group (63.3%) in relation to the comparison group (15.5%) (χ2=28.9, p<0.001), which gives grounds to consider bacteria, as one of the markers of the development of purulent-septic complications of acute pancreatitis.

Keywords: Helicobacter pylori, acute pancreatitis, etiology, purulent-septic complications, diagnosis, treatment
p. 542-548 of the original issue
References
  1. Rasslan R, Novo FC, Rocha MC, Bitran A, Rocha MS, Bernini CO, Rasslan S, Utiyama EM. Pancreatic necrosis and gas in the retroperitoneum: treatment with antibiotics alone. Clinics (Sao Paulo). 2017 Feb;72(2):87-94. Published online 2017 Feb. doi: 10.6061/clinics/2017(02)04
  2. Roberts JA, Roger C, De Waele JJ. Personalized antibiotic dosing for the critically ill. Intensive Care Med. 2019 May;45(5):715-18. doi: 10.1007/s00134-019-05522-3
  3. Mowbray NG, Ben-Ismaeil B, Hammoda M, Shingler G, Al-Sarireh B. The microbiology of infected pancreatic necrosis. Hepatobiliary Pancreat Dis Int. 2018 Oct;17(5):456-60. doi: 10.1016/j.hbpd.2018.08.007
  4. Moka P, Goswami P, Kapil A, Xess I, Sreenivas V, Saraya A. Impact of antibiotic-resistant bacterial and fungal infections in outcome of acute pancreatitis. Pancreas. 2018 Apr;47(4):489-94. doi: 10.1097/MPA.0000000000001019
  5. Sarsenbaeva AS, Domracheva EV, Rustamov MN. Clinical relevance Helicobacter pylori genotypes in patients with chronic pancreatitis and concomitant infections Helicobacter Pylori. Experimental and Clinical Gastroenterology. 2016;(5):22-27. (In Russ.)
  6. Banić M, Franceschi F, Babić Z, Gasbarrini A. Extragastric manifestations of Helicobacter pylori infection. Helicobacter. 2012 Sep;17(Suppl 1):49-55. doi: 10.1111/j.1523-5378.2012.00983.x
  7. Matrakool L, Tongtawee T, Bartpho T, Dechsukhum C, Loyd RA, Kaewpitoon SJ, Kaewpitoon N. Improved detection of Helicobacter pylori infection and premalignant gastric mucosa using conventional white light source gastroscopy. Asian Pac J Cancer Prev. 2016;17(4):2099-103. doi: 10.7314/apjcp.2016.17.4.2099
  8. Khan J, Pelli H, Lappalainen-Lehto R, Järvinen S, Sand J, Nordback I. Helicobacter pylori in alcohol induced acute pancreatitis. Scand J Surg. 2009;98(4):221-4. doi: 10.1177/145749690909800405
  9. Youssefi M, Tafaghodi M, Farsiani H, Ghazvini K, Keikha M. Helicobacter pylori infection and autoimmune diseases; Is there an association with systemic lupus erythematosus, rheumatoid arthritis, autoimmune atrophy gastritis and autoimmune pancreatitis? A systematic review and meta-analysis study. J Microbiol Immunol Infect. 2021 Jun;54(3):359-69. doi: 10.1016/j.jmii.2020.08.011
  10. Bulajic M, Panic N, Löhr JM. Helicobacter pylori and pancreatic diseases. World J Gastrointest Pathophysiol. 2014 Nov 15;5(4):380-83. doi: 10.4291/wjgp.v5.i4.380
  11. Best LM, Takwoingi Y, Siddique S, Selladurai A, Gandhi A, Low B, Yaghoobi M, Gurusamy KS. Non-invasive diagnostic tests for Helicobacter pylori infection. Cochrane Database Syst Rev. 2018 Mar 15;3(3):CD012080. doi: 10.1002/14651858.CD012080.pub2
  12. Khan J, Pelli H, Lappalainen-Lehto R, Järvinen S, Sand J, Nordback I. Helicobacter pylori in alcohol induced acute pancreatitis. Scand J Surg. 2009;98(4):221-24. doi: 10.1177/145749690909800405
  13. Stepanov YM, Budzak IY. Maastricht consensus-5: analytical review of statements. Gastroenterology, 51(1), 3645. doi: 10.22141/2308-2097.51.1.2017.97870 (In Russ.)
Address for correspondence:
01601, Ukraine, Kiev,
Blvd T.Shevcheko, 13,
A.A. Bogomolets National
Medical University,
the Surgery Department No 2?
tel.: +380 (67) 698 86 17,
e-mail:ganoli@ukr.net,
Hanol Ihor V.
Information about the authors:
Kolosovych Ihor V., MD, Professor, Head of the surgery Department No2, A.A. Bogomolets National Medical University, Kiev, Ukrain.
https://orcid.org/0000-0002-2031-4897
Hanol Ihor V., PhD, Associate Professor of the Surgery Department No2, A.A. Bogomolets National Medical University, Kiev, Ukrain.
https://orcid.org/0000-0002-3470-2102
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