Journal of Clinical & Experimental Pathology
Open Access

Abstract

Pseudocyst of the pancreas are the most common variant of local complications of acute pancreatitis, accounting for 50-92% of the destructive forms. In 81% of cases are pseudocysts complicated course. This is due to insufficiently developed their diagnosis and the lack of criteria for choice of treatment in these patients. The foregoing shows the relevance of the method of determining the indications for surgical treatment, and to identify markers of prognosis of complications of pancreatic pseudocysts Purpose: To examine the characteristics of free-radical processes in the body as a significant predictor of complications of pancreatic pseudocysts, depending on their degree of development. Materials and Methods: The analysis of the examination and treatment of 115 patients. Group A consisted of 25 healthy subjects (mean age 37 ± 8,6 years). Core group of 90 patients with pancreatic pseudocysts. The average age of patients with pancreatic pseudocysts was 46,9 ± 9,3 years (range 18 to 73 years). The complex diagnostic procedures included fibroezofagogastroduodenoscopy (FEGDS), ultrasound (U.S.), computed tomography (CT), endoscopic retrograde cholangiopancreatography (ERCP), and biochemical study of the contents of cysts. Diagnosis of the disease was performed by clinical symptom, according to instrumental and laboratory tests. Studies performed on patients with informed consent in accordance with ethical standards, regulated the Declaration of Helsinki 2000 Results and Discussion: There was a significant increase in the activity of G-6-PDG - the main enzyme pentose phosphate cycle, catalyzing the formation of reduced equivalents on immature pseudocysts of the pancreas in relation to patients with formed pseudocysts. Despite a significant increase in the activity of G-6-PDG, the level of reduced glutathione in immature pseudocysts remained lower than in the control group and patients with formed pseudocysts. The content of uric acid in all patients with pancreatic pseudocysts significantly higher than control values. However, in this case the operation of antioxidant protection was not effective in the group unformed pseudocysts, as evidenced by low levels of reduced glutathione and MDA high numbers in the blood of these patients. Marked inverse correlation between the content of malondialdehyde and glutathione in erythrocytes (Spearman's rank correlation coefficient r = - 896, p < 0,01). Thus, increased lipid peroxidation in immature pseudocysts of the pancreas occurs against the oppression of the components of the endogenous antioxidant systems like glutathione and glutathione reductase. Toxic effects of free radical oxidation products contributes to the maintenance of the inflammatory response and tissue ischemia in patients with immature pseudocysts of the pancreas. We observed a direct correlation between the content of MDA and ETA in plasma and erythrocytes (r = 0,845; p <0,05 and r = 0,883; p <0,05). The intensification of free radical oxidation and circulation of endotoxin substances in body fluids in various pathological processes inevitably lead to changes in the immune system of the body (10-13). As a result of the study, the following conclusions: 1. Pseudocyst of the pancreas characterized by non-specific polymorphic pattern with the absence of pathognomonic clinical signs 2. The activity of glutathione reductase in the blood was low in most patients with cystic Postnecrotic immature pancreas 3. Activity of G-6-PDG, glutathione reductase and glutathione indicators can be used as markers of prognosis of complications of pancreatic pseudocysts, depending on their degree of formation

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