Continuous regional arterial infusion and laparotomic decompression for severe acute pancreatitis with abdominal compartment syndrome

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	Continuous regional arterial infusion and laparotomic decompression for severe acute pancreatitis with abdominal compartment syndrome
	Deng, Zhi-Gang ; Zhou, Jian-Yin ; Yin, Zhen-Yu ; Peng, You-Yuan ; Wang, Fu-Qiang ; Wang, Xiao-Min ; Deng ZG(邓志刚) ; Zhou JY(周剑寅) ; Yin ZY(尹震宇) ; Wang FQ(王付强) ; Wang XM(王效民)
刊名	http://dx.doi.org/10.3748/wjg.v17.i44.4911
	2011-11-28
关键词	ACUTE NECROTIZING PANCREATITIS PROTEASE INHIBITOR CLASSIFICATION-SYSTEM DOUBLE-BLIND APACHE-II OCTREOTIDE TRIAL MANAGEMENT
英文摘要	National Natural Science Foundation of China [30872484]; AIM: To evaluate the therapeutic effects of abdominal decompression plus continuous regional arterial infusion (CRAI) via a drug delivery system (DDS) in severe acute pancreatitis (SAP) patients with abdominal compartment syndrome (ACS). METHODS: We presented our recent experience in 8 patients with SAP. The patients developed clinical ACS, which required abdominal decompression. During the operation, a DDS was inserted into the peripancreatic artery (the catheter was inserted from the right gas-troepiploic artery until it reached the junction between the pancreaticoduodenal and gastroduodenal artery). Through this DDS, a protease inhibitor, antibiotics and octreotide were infused continuously. The duration of the regional artery infusion ranged from 8 to 41 d. The outcomes and the changes in the APACHE. score, computed tomography (CT) severity index and intra-abdominal pressure (IAP) of the patients were retrospectively evaluated. RESULTS: Eight patients with an initial APACHE. score of 18.9 (range, 13-27) and a Balthazar CT severity index of 9.1 (range, 7-10) developed severe local and systemic complications. These patients underwent subsequent surgical decompression and CRAI therapy because of intra-abdominal hypertension (IAH). After a mean interval of 131.9 +/- 72.3 d hospitalization, 7 patients recovered with decreased APACHE. scores, CT severity indexes and IAP. The mean APACHE. score was 5.4 (range, 4-8), the CT severity index was 2.3 (range, 1-3), and IAP decreased to 7.7 mmHg (range, 6-11 mmHg) 60 d after operation. One patient died of multiple organ failure 1 wk after surgery. CONCLUSION: CRAI and laparotomic decompression might be a therapeutic option for SAP patients with ACS. (C) 2011 Baishideng. All rights reserved.
语种	英语
出版者	WORLD J GASTROENTERO
内容类型	期刊论文
源URL	[http://dspace.xmu.edu.cn/handle/2288/93241]
专题	医学院－已发表论文
推荐引用方式 GB/T 7714	Deng, Zhi-Gang,Zhou, Jian-Yin,Yin, Zhen-Yu,et al. Continuous regional arterial infusion and laparotomic decompression for severe acute pancreatitis with abdominal compartment syndrome[J]. http://dx.doi.org/10.3748/wjg.v17.i44.4911,2011.
APA	Deng, Zhi-Gang.,Zhou, Jian-Yin.,Yin, Zhen-Yu.,Peng, You-Yuan.,Wang, Fu-Qiang.,...&王效民.(2011).Continuous regional arterial infusion and laparotomic decompression for severe acute pancreatitis with abdominal compartment syndrome.http://dx.doi.org/10.3748/wjg.v17.i44.4911.
MLA	Deng, Zhi-Gang,et al."Continuous regional arterial infusion and laparotomic decompression for severe acute pancreatitis with abdominal compartment syndrome".http://dx.doi.org/10.3748/wjg.v17.i44.4911 (2011).