[Indications for and efficiency of peritoneal lavage in severe acute pancreatitis].
Peritoneal lavage was developed as a simple method to evacuate the ascitic fluid associated with pancreatitis. Although a number of studies demonstrated its efficacy in improvement of clinical manifestations, a meta-analysis of randomized control studies could not reveal its effectiveness on mortality or morbidity in severe acute pancreatitis. However, it has been well established that the ascitic fluid with pancreatitis is extremely toxic and to induce organ damage due to apoptotic cell death. Particularly, we have recently found that the ascitic fluid with pancreatitis can induce bacterial translocation due to the increase of gut permeability. Therapeutic strategy of peritoneal lavage, i.e. evacuation of toxic substances from peritoneal cavity, should be reevaluated to achieve further improvement of treatment result of severe acute pancreatitis.
Takeyama
Yoshifumi
Y
Division of Hepato-biliary-pancreatic Surgery, Department of Surgery, Kinki University School of Medicine.
D000208:Acute Disease; D000818:Animals; D017209:Apoptosis; D001202:Ascitic Fluid; D001920:Bradykinin; D053938:DNA Fragmentation; D006632:Histamine; D006801:Humans; D010195:Pancreatitis / Q000628:therapy*; D010533:Peritoneal Lavage / Q000009:adverse effects / Q000379:methods; D012720:Severity of Illness Index
D006632:Histamine; D001920:Bradykinin