[Laparoscopy combined with endoscopic and digital subtraction angiography for treatment of severe acute pancreatitis].
OBJECTIVE
To study the effect of laparoscopy combined with endoscopic and digital subtraction angiography in the treatment of severe acute pancreatitis (SAP).


METHODS
Nine-seven SAP patients were randomly divided into group A (n=32) with conventional treatment and group B (n=35) with combined treatment with laparoscopy, endoscopic and digital subtraction angiography in addition to the conventional treatment. The clinical indices and therapeutic effects in the 2 groups were compared.


RESULTS
After treatment, the patients in group B had significantly lower APACHE score than those in group A (P<0.05), with also better hepatic, renal and lung functions (P<0.05). The serum TNF-alpha and IL-1beta levels was significantly lower, but IL-10 significantly higher in group B (P<0.05). The CT SPN was significantly lowered in group B as compared with that in group A (P<0.05). The patients in group B had significantly lower rate of organ failure (P<0.01) and higher successful rate in organ failure management (P<0.05), with also lowered inhospital mortality than those in group A (P<0.05).


CONCLUSIONS
Laparoscopy combined with endoscopic pancreaticobiliary duct drainage and digital subtraction angiography in addition to conventional treatment significantly improves the outcome and decreases the mortality of SAP patients.
Liu
Hao
H
Department of Surgery, Integrated Chinese and Western Medicine Hospital, Southern Medical University, Guangzhou 510310, China.
Chen
Kai-yun
KY
Xiang
Guo-an
GA
Wang
Han-ning
HN
Xiao
Fang-lian
FL
D015901:Angiography, Digital Subtraction; D016145:Endoscopy, Digestive System; D005260:Female; D006801:Humans; D053583:Interleukin-1beta / Q000097:blood; D007668:Kidney / Q000503:physiopathology; D010535:Laparoscopy; D008099:Liver / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure; D010195:Pancreatitis / Q000097:blood / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000097:blood
D053583:Interleukin-1beta; D014409:Tumor Necrosis Factor-alpha