Valores de lipasa en pancreatitis biliar leve y su implicación en el manejo quirúrgico temprano

Abstract

Background: Mild acute biliary pancreatitis is a frequent pathology, with a favorable evolution if complications are avoided such as: recurrent pancreatitis, cholecystitis, cholangitis, choledocolithiasis, all of them preventable by performing an early surgical treatment. When to perform the intervention? Is not defined yet. This work reviews the evolution of the lipase enzyme until its standardization and surgical treatment. Method: a prospective descriptive study was carried out, from January to December 2014, in patients with mild acute biliary pancreatitis between 18 and 75 years old, with a follow up from their admission, monitoring their lipase values each 24 hours until its standardization, treatment and discharge. The data were introduced and tabulated in the program SPSS v15. Results: Sixty-eight patients were studied, with a median age 44.85±17.4 years, 51 (75%) being women. For the biliary etiological diagnosis was found: dilated common bile duct >8mm in 27.9%, choledocolithiasis 30.9%, cholelithiasis 80.9%, the elevation of the glutamic pyruvic transaminase (SGPT) three times its normal value and glutamic oxaloacetic transaminase (SGOT) 82.4% and 80.9% respectively. The lipase enzyme was standardized in 60.35 ± 29.46 hours. The procedures performed: laparoscopic cholecystectomy in 49 cases (72.1%), endoscopic retrograde cholangiopancreatography (ERCP) in 12 cases (17.6%). The hospital stay was of 6.75 ± 2.23 days. Conclusion: In mild biliary acute pancreatitis the lipase’s values standardize before 72 hours and it is a good option to define the moment in which the surgical procedures will be performed