Continuous regional arterial infusion therapy with gabexate mesilate for severe acute pancreatitis.
OBJECTIVE
To evaluate the efficacy of continuous regional arterial infusion therapy (CRAI) with gabexate mesilate and antibiotics for severe acute pancreatitis (SAP).


METHODS
We conducted a prospective study on patients who developed SAP with or without CRAI. Out of 18 patients fulfilled clinical diagnostic criteria for SAP in Japan, 9 patients underwent CRAI, while 9 patients underwent conventional systemic protease inhibitor and antibiotics therapy (non-CRAI). CRAI was initiated within 72 h of the onset of pancreatitis. Gabexate mesilate (2400 mg/d) was continuously administered for 3 to 5 d. The clinical outcome including serum inflammation-related parameters were examined.


RESULTS
The duration of abdominal pain in the CRAI group was 1.9+/-0.26 d, whereas that in the non-CRAI group was 4.3+/-0.50. The duration of SIRS in the CRAI group was 2.2+/-0.22 d, whereas that in the non-CRAI group was 3.2+/-0.28. Abdominal pain and SIRS disappeared significantly in a short period of time after the initiation of CRAI using gabexate mesilate. The average length of hospitalization significantly differed between the CRAI and non-CRAI groups, 53.3+/-7.9 d and 87.4+/-13.9 d, respectively. During the first two weeks, levels of serum CRP and the IL6/IL10 ratio in the CRAI group tended to have a rapid decrease compared to those in the non-CRAI group.


CONCLUSIONS
The present results suggest that CRAI using gabexate mesilate was effective against SAP.
Ino
Yoshifumi
Y
Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, and Department of Gastroenterology, Saiseikai Fukuoka General Hospital, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan.
Arita
Yoshiyuki
Y
Akashi
Tetsuro
T
Kimura
Toshinari
T
Igarashi
Hisato
H
Oono
Takamasa
T
Furukawa
Masayuki
M
Kawabe
Ken
K
Ogoshi
Keiichiro
K
Ouchi
Jiro
J
Miyahara
Toshihiko
T
Takayanagi
Ryoichi
R
Ito
Tetsuhide
T
D015746:Abdominal Pain / Q000188:drug therapy / Q000209:etiology; D000208:Acute Disease; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D002097:C-Reactive Protein / Q000378:metabolism; D004359:Drug Therapy, Combination; D005260:Female; D016670:Gabexate / Q000008:administration & dosage*; D006801:Humans; D018836:Inflammation Mediators / Q000097:blood; D007261:Infusions, Intra-Arterial; D016753:Interleukin-10 / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D007564:Japan; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000150:complications / Q000188:drug therapy* / Q000276:immunology; D011446:Prospective Studies; D015842:Serine Proteinase Inhibitors / Q000008:administration & dosage*; D012720:Severity of Illness Index; D018746:Systemic Inflammatory Response Syndrome / Q000188:drug therapy / Q000209:etiology; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; C508600:IL6 protein, human; D018836:Inflammation Mediators; D015850:Interleukin-6; D015842:Serine Proteinase Inhibitors; D016753:Interleukin-10; D016670:Gabexate; D002097:C-Reactive Protein