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

Abstract

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. Мethods. 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 biopsyspecimensof 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 author’s 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 Нelicobacter 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. What this paper adds The role of Helicobacter pylori (HP) in the pathogenesis of acute pancreatitis has been studied for the first time and its value as a marker for septic complications development of acute pancreatitis is shown. It allowed optimizing the etiotropic antibiotic therapy for this disease.