Roux-en-y biliary by-pass – a new approach in the treatment of hypertriglyceridemia induced recurrent acute pancreatitis. Clinical case study

• Authors: Krzysztof Szwedziak , Katarzyna Muras , Janusz Strzelczyk
• Languages of publication: EN

Abstracts

EN

Acute pancreatitis is a disease with significant mortality. Hypertriglyceridemia (HTG) is the third most common etiological factor of this disorder after alcohol and gall-stones. The authors presented a case of 42-years old caucasian female who was hospitalized due to recurrence of acute pancreatitis. She had been diagnosed with HTG. She had earlier seven episodes of acute pancreatitis. Endoscopic papillotomy and conservatory treatment didn’t change her complaints and she was consented for surgery. Exclusion of distal part of bile duct was performed. The common bile duct was anastomosed side-to-side to the 70 cm long Roux loop of the jejunum with the ligation of the distal part of the common bile duct. Following the surgery authors observed normalization of amylase, lipase, leukocytosis and CRP levels. During six months after procedure patient didn’t have any new episode of pancreatitis. Exclusion of distal part of bile duct may be a useful tool in surgical treatment of recurrent acute hypertriglyceridemia-induced pancreatitis.

Keywords

EN

acute pancreatitis; hypertriglyceridemia; surgical treatment

• Publisher: De Gruyter Open
• Journal: Polish Journal of Surgery
• Year: 2013
• Volume: 85
• Issue: 3
• Pages: 137-140

Dates

published

1 - 03 - 2013

online

20 - 04 - 2013

Contributors

author

Krzysztof Szwedziak

• Department of General and Transplant Surgery, Barlicki University Hospital in Łódź, Kierownik: prof. dr hab. J. Strzelczyk

author

Katarzyna Muras

• Department of Nephrology, Hypertension and Renal Transplantation, University Hospital in Łódź, Kierownik: prof. dr hab. M. Nowicki Barlicki

author

Janusz Strzelczyk

• Department of General and Transplant Surgery, Barlicki University Hospital in Łódź, Kierownik: prof. dr hab. J. Strzelczyk

References

• 1. Liang V, Go W: Etiology and epidemiology of pancreatitis in the United States. In: Bradley EL III, editor. Acute pancreatitis: diagnosis and therapy. New York, Raven Press 1994.
• 2. Searles GE, Ooi TC : Underrecognition of chylomicronemia as a cause of acute pancreatitis. CMA J 1992; 147: 1806-08.
• 3. Toskes PP: Hyperlipidemic pancreatitis. GastroenterolClin North Am 1990; 19: 783-91.
• 4. Farmer RG, Winkelman EI , Brown HB , LewisLA . Hyperlipoproteinemia and pancreatitis. Am J Med 1973; 54: 161-165.[Crossref][PubMed]
• 5. Rivellese AA , De Natale C, Di Marino L et al.: Exogenous and endogenous postprandial lipid abnormalities in type 2 diabetic patients with optimal blood glucose control and optimal fasting triglyceride levels. J Clin Endocrinol Metab 2004; 89: 2153-59.
• 6. Castro MR , Nguyen TT , O’Brien T: Clomipheneinduced severe hypertriglyceridemia and pancreatitis. Mayo Clin Proc 1999; 74: 1125-28.[PubMed][Crossref]
• 7. Sun H, Tang H, Jiang S et al.: Gender and metabolic differences of gallstone diseases. World JGastroenterol 2009; 15: 1886-91.[Crossref]
• 8. Alagozlu H, Mehmet C, Karakan T et al.: Heparin and Insulin in the Treatment of Hypertriglyceridemia- Induced Severe Acute Pancreatitis. DigDis Sci 2006; 51: 931-33.
• 9. Kadikoylu G, Yavasoglu I, Bolaman Z: Plasma exchange in severe hypertriglyceridemia a clinical study. Transfus Apher Sci 2006; 34: 253-57.[PubMed][Crossref]
• 10. Hovland A, Hardersen R, Mollnes TE et al.: Selective Whole Blood Lipoprotein Apheresis to Prevent Pancreatitis in Drug Refractory Hypertriglyceridemia. JOP. J Pancreas (Online) 2010; 11: 467-69.
• 11. Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) Final report. NIH publication No 02-5215. Bethesda Md.: National Heart, Lung, and Blood Instutitute, 2002.
• 12. Nguyen NT , Varela E, Sabio A et al.: Resolution of hyperlipidemia after laparoscopic Roux-en-Y gastric bypass. J Am Coll Surg 2006; 203: 24-29.
• 13. Zlabek JA, Grimm MS , Larson CJ et al.: The effect of laparoscopic gastric by-pass surgery on dyslipidemia in severely obese patients. Surg ObesRelat Dis 2005; 1: 537-42.
• 14. Miller GJ: Lipoproteins and thrombosis: effects of lipid lowering. Curr Opin Lipidol 1995; 6: 38-42.[PubMed][Crossref]
• 15. Bai H, Liu BW , Deng ZY et al.: Plasma verylow- density lipoprotein, low-density lipoprotein, and high-density lipoprotein oxidative modification induces procoagulant profiles in endogenous hypertriglyceridemia. Free Radic Biol Med 2006; 40: 1796-1803.

Identifiers

DOI

10.2478/pjs-2013-0024