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Objective To investigate the efficacy and safety of continuous regional arterial infusion (CRAI) in patients with severe acute pancreatitis (SAP).Methods One hundred SAP patients (including 41 gallstone,26 alcoholism,13 hypertriglyceridemia,11 after heavy meals,and 9 unknown) who were admitted into our hospital from January 2013 to October 2017 were assigned to the CRAI group (n =58) and the control group (n =42).The levels of laboratory measurements,hospitalization time and costs,complications and outcomes were compared between the two groups.Results On the sixth and tenth day of treatment,the levels of white blood cell,hemodiastase,urine amylase,blood glucose,blood calcium and APACHE-Ⅱ score improved in both the 2 groups.The degrees of improvement in the CRAI group were better than that in the control group.The abdominal pain relief time [(3.3± 1.2)d vs.(5.9±2.3)d],hemodiastase recovery time [(7.9±1.8)d vs.(13.3±2.5)d],and hospitalization stay [(21.3±3.6)d vs.(32.4±4.3)d] were shorter in the CRAI group.The costs were similar in the two groups.Retroperitoneal infection,pancreatic pseudocyst,and pancreatic drainage were less in the CRAI group.The improved and cure rates were 94.8％ and 70.7％ in the CRAI group,which were higher than those in the control group (71.4％ and 47.6％,respectively).Moreover,the ineffective treatment and mortality rates were 5.2％ and 1.7％ in the CRAI group,which were lower than those in the control group (28.6％ and 14.3％,respectively).Conclusions CRAI was an efficacious and safe treatment for patients with SAP.It can be used as an alternative to other effective treatments.
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Objective To explore the ideal choice of feeding artery which is used for regional arterial infusion (RAI) in severe acute pancreatitis. Methods Forty-five patients with SAP were treated with RAI. The ideal feeding artery was that can supply entire pancreas according to arteriography and can maximize concentration of drug at pancreatic tissue. The pancreatic arteriography was considered as the final objective evidence for choice. Results (1)Gastroduodenal artery was chosen as feeding artery in forty-four cases, and superior mesenterlc artery was chosen in only one case because of vascular abnormity. (2)According to splenic arteriography, blood of splenic artery was supplied to spleen chiefly, and only partial tail of pancreas was applied by splenic artery. (3)According to celiac trunk arteriography, blood of celiac trunk could be supplied to entire pancreas, but a considerable proportion of the total blood was supplied to spleen through splenic artery and liver through hepatic artery proper.Therefore, the drug utilization index was lower. (4)According to gastroduodenal arteriography, blood of gastroduodenal artery could be supplied to entire pancrea, and almost all of the blood that contains drug flowed into pancreas. Therefore, the drug utilization index was higher. Conclusions Gastroduodenal artery is the ideal choice of artery which is used for regional intra-arterial infusion in sever acute pancreatitis. Pancreatic arteriography should be applied routinely when yever acute pancreatitis was treated with RAI.
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Objective To evaluate the potential of interventional regional arterial infusion for severe acute pancreatitis (SAP). Methods Regional arterial infusion with somatostatin and antibiotic was performed in 20 cases of SAP within 4 hours after diagnosis confirmed,and pressurized infusion lasted for 5 days. Another 28 cases of SAP as control group received drug treatment all over the body. The SAP clinical data such as symptom,mortality,complication rate and stay time in hospital were analysed in two groups. Results There were significant differences in remission,serum amylase,urine amylase and lipase between the regional and total infusion groups. The stay time in hospital,mortality,complication and operation rate were lower in regional infusion group than those of control group(P