ORIGINAL ARTICLE   

Minerva Chirurgica 2019 June;74(3):207-12

DOI: 10.23736/S0026-4733.18.07813-6

Copyright © 2018 EDIZIONI MINERVA MEDICA

lingua: Inglese

Percutaneous catheter drainage combined with peritoneal dialysis for treating acute severe pancreatitis: a single-center prospective study

Wenhao ZHANG, Jiakui SUN, Xiao SHEN, Yinying XUE, Chao MENG, Shoutao YUAN ✉

Department of Critical Care Medicine, Nanjing First Hospital, Nanjing Medical University, Nanjing, China

BACKGROUND: To investigate the efficacy of percutaneous catheter drainage (PCD) and peritoneal dialysis (PD) in the treatment of severe acute pancreatitis (SAP) and its underlying mechanism.
METHODS: Totally 64 SAP patients were included in our study and randomly assigned into PCD+PD group (the combination group, N.=32) and convention group (N.=32). SAP patients in the combination group were treated with percutaneous catheter drainage combined with peritoneal dialysis, while those in the convention group were treated with conventional method. The treatment efficacy of both methods were evaluated by comparing levels of plasma inflammatory cytokines (IL-6, IL-8, TNF-α, C-reactive protein, procalcitonin and leukocyte count), relative indexes of important organs (aspartate aminotransferase, alanine aminotransferase, creatinine and urea nitrogen) and other clinical data (amelioration time of abdominal pain and abdominal distension, Balthazar CT scores, acute physiology and chronic health enquiry II score, length of hospital stay, complications and prognosis).
RESULTS: The expression levels of inflammatory cytokines were significantly decreased in the combination group in a time-dependent manner in comparison with those of the convention group. In addition, the amelioration time of abdominal pain and abdominal distension, length of hospital stay, Balthazar CT scores and the acute physiology and chronic health care II scores in the combination group were also significantly decreased in comparison with those of the convention group.
CONCLUSIONS: The combination treatment of PCD and PD effectively relieves the clinical symptoms of SAP by clearing plasma inflammatory cytokines.

KEY WORDS: Catheters - Drainage - Peritoneal dialysis - Pancreatitis