Altay KANDEMİR, Ismail TASKIRAN, Sezgin VATANSEVER, Mustafa ÇELİK, İrfan YAVAŞOĞLU, Mevlüt TÜRE, Adil ÇOŞKUN, Mehmet Hadi YAŞA

Therapeutic Plasma Exchange and Conservative Treatment Comparison in Patients with Hypertriglyceridemiainduced Acute Pancreatitis

Objective: Hypertriglyceridemia is the third most common cause of acute pancreatitis. Immediate triglyceride level lowering is beneficial in patients with severe hypertriglyceridemia [triglyceride (TG) >1,000 mg/dL]. This study aimed to compare the severity of acute pancreatitis, in-hospital mortality, and local and systemic complications, as well as hospitalization duration between patients with hypertriglyceridemia-induced acute pancreatitis treated with conservative treatment only and with therapeutic plasma exchange (TPE) in addition to conservative treatment. Materials and Methods: A total of 120 patients diagnosed with hypertriglyceridemia-induced acute pancreatitis treated with TPE in addition to conservative treatment (group 1) or conservative treatment only (group 2) participated in the study. Results: Group 1 consisted of 38 patients (9 females and 29 males) and group 2 had 82 patients (29 females and 53 males). No difference was found between the two groups regarding patient characteristics. The TG levels in group 1 decreased by 56.8% in one treatment session. The rate of patients with moderately severe acute pancreatitis + severe acute pancreatitis in group 1 was 36.8%, whereas 59.8% in group 2 (p=0.029). The local complication rate was 34.2% and 57.3% in group 1 and group 2, respectively (p=0.031). No significant difference was found between the groups regarding organ failure, systemic complication, hospitalization duration, and in-hospital mortality rates. Conclusion: Our study revealed that TPE treatment is effective in reducing local complications (especially pancreatic pseudocyst).

Hipertrigliseridemi İlişkili Akut Pankreatit Hastalarında Terapötik Plazma Değişimi ve Konservatif Tedavinin Karşılaştırılması

Amaç: Hipertrigliseridemi akut pankreatitin en sık 3 nedeninden biridir. Ciddi hipertrigliseridemisi olan hastalarda [trigliserid (TG) >1.000 mg/dL] TG düzeyinin hemen düşürülmesi faydalı olabilir. Çalışmamızda hipertrigliseridemi ilişkili akut pankreatit hastalarına uygulanan konservatif tedavi ile konservatif + terapötik plazma değişimi tedavilerini mortalite, hastane yatış süresi ve lokal-sistemik komplikasyonları baz alarak karşılaştırdık. Gereç ve Yöntemler: Hipertrigliseridemi ilişkili akut pankreatit tanısı olup konservatif tedavi + terapötik plazma değişimi tedavisi alanlar (grup 1) ve sadece konservatif tedavi alan (grup 2) toplam 120 hasta çalışmaya alınmıştır. Bulgular: Grup 1’de 38 (9 kadın, 29 erkek), grup 2’de 82 (29 kadın, 53 erkek) hasta mevcuttu. İki grup arasında hasta özellikleri açısından fark yoktu. Grup 1’de bir seans tedavi sonrası TG düzeyi %56,8 azaldı. Grup 1 hastalarının %36,8’i orta + ciddi düzeyde pankreatit iken, grup 2 hastalarında bu oran %59,8 idi (p=0,029). Lokal komplikasyon oranları grup 1 ve grup 2 hastalarda sırası ile %34,2 ve %57,3 idi (p=0,031). Gruplar arasında organ yetmezliği, sistemik komplikasyonlar, hastane yatış süresi ve hastane içi mortalite açısından fark yoktu. Sonuç: Çalışmamızda, terapötik plazma değişimi tedavisi lokal komplikasyonları (özellikle pankreatik psödokist) azaltmada etkili olarak bulunmuştur

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