title: Therapeutic efficacy of continuous arterial infusion of the protease inhibitor and the antibiotics and via celiac and superior mesenteric artery for severe acute pancreatitis--pilot study.
abstract: OBJECTIVE
  Severe acute pancreatitis is poor prognosis. Continuous regional arterial infusion of protease inhibitors and antibiotics were developed in Japan. We evaluated whether arterial infusion both celiac artery and superior mesenteric artery for this disease would reduce mortality.
  
  
  METHODS
  Seventeen patients were treated arterial infusion of protease inhibitor and antibiotics via both celiac artery and superior mesenteric artery. Changes of Acute Physiology and Chronic Health Evaluation II score and mortality were evaluated.
  
  
  RESULTS
  Arterial infusion via two routes reduced the mortality rate and improved Acute Physiology and Chronic Health Evaluation II score. The overall mortality rate was 11.8%. The mortality rate in patients in whom were treated within 3days after the onset was significantly lower than that in patients in whom were treated without 3days after the onset.
  
  
  CONCLUSIONS
  Arterial infusion via superior mesenteric artery might prevent both bacterial translocation and non-occlusive mesenteric ischemia. Continuous arterial infusion both celiac artery and superior mesenteric artery might be effective for reducing mortality and preventing the development of pancreatitis, especially when initiated within 3 days after the onset. Further prospective randomized studies using a larger number of patients are required.
authors: Department of Gastroenterology, Saiseikai Niigata Second Hospital, Niigata, Japan. toruishi@ngt.saiseikai.or.jp
authors: Toru
authors: T
authors: Ishikawa
authors: Michitaka
authors: M
authors: Imai
authors: Hiroteru
authors: H
authors: Kamimura
authors: Takashi
authors: T
authors: Ushiki
authors: Atsunori
authors: A
authors: Tsuchiya
authors: Tadayuki
authors: T
authors: Togashi
authors: Kouji
authors: K
authors: Watanabe
authors: Kei-ichi
authors: K
authors: Seki
authors: Hironobu
authors: H
authors: Ohta
authors: Toshiaki
authors: T
authors: Yoshida
authors: Tomoteru
authors: T
authors: Kamimura
mesh_terms: D018806:APACHE; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D002445:Celiac Artery; D005260:Female; D006801:Humans; D007261:Infusions, Intra-Arterial; D007564:Japan / Q000453:epidemiology; D008297:Male; D017538:Mesenteric Artery, Superior; D008875:Middle Aged; D010195:Pancreatitis / Q000188:drug therapy* / Q000401:mortality; D010865:Pilot Projects; D011480:Protease Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D011480:Protease Inhibitors