title: The efficiency of continuous regional intra-arterial infusion in the treatment of infected pancreatic necrosis.
abstract: OBJECTIVE
  Our aim was to investigate the efficiency of continuous regional intra-arterial infusion (CRAI) with antisecretory agents and antibiotics in the treatment of infected pancreatic necrosis.
  
  
  METHODS
  CRAI was used as a new clinical technique to treat acute pancreatitis patients during a 4-year period at the First Affiliated Hospital, Wenzhou Medical College, China. In this retrospective study, thirty-four patients with proven infected pancreatic necrosis were included. Twelve patients were treated with CRAI, and were matched according to age, sex, APACHE II scores, Ranson scores and remote organ dysfunction, with 22 patients with IPN treated surgically. The clinical outcome following surgery and CRAI were compared.
  
  
  RESULTS
  No difference was found between the two groups when comparing age, gender, APACHE II scores, Ranson scores and remote organ dysfunction (p > 0.05). The patients treated with CRAI had a lower incidence of complications (33.3% vs 72.7%), duration of hospitalization (27.1 ± 4.7 days vs 43.0 ± 12.0 days) and cost of hospitalization (4.09 ± 1.64 thousand RMB vs 8.77 ± 3.74 thousand RMB) as compared to patients treated with surgery (p < 0.05). The survival rate was significantly higher in the CRAI group as compared to the surgical group (91.7% vs 63.6%; p < 0.01). However, the two groups had similar rates of concomitant operative treatment and incidence of remote organ dysfunction (p > 0.05).
  
  
  CONCLUSIONS
  CRAI or CRAI in combination with abscess drainage seemingly improve the clinical outcome in patients with infected pancreatic necrosis. Further confirmative prospective randomized multicenter studies are warranted prior to broad introduction of the CRAI concept.
authors.affiliation: Department of Surgery, The First Affiliated Hospital, Wenzhou Medical College, 2 Fuxue Lane, Wenzhou, Zhejiang Province, China. drzhoumengtao@hotmail.com
authors.forename: Mengtao
authors.initials: M
authors.lastname: Zhou
authors.forename: Bicheng
authors.initials: B
authors.lastname: Chen
authors.forename: Hongwei
authors.initials: H
authors.lastname: Sun
authors.forename: Xiaolei
authors.initials: X
authors.lastname: Chen
authors.forename: Zhengping
authors.initials: Z
authors.lastname: Yu
authors.forename: Hongqi
authors.initials: H
authors.lastname: Shi
authors.forename: Jiangao
authors.initials: J
authors.lastname: Yao
authors.forename: Zhengkeng
authors.initials: Z
authors.lastname: Xu
authors.forename: Qiyu
authors.initials: Q
authors.lastname: Zhang
authors.forename: Roland
authors.initials: R
authors.lastname: Andersson
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D002438:Cefoperazone / Q000008:administration & dosage; D002681:China; D004322:Drainage; D005260:Female; D006760:Hospitalization / Q000191:economics; D006801:Humans; D007261:Infusions, Intra-Arterial; D059413:Intraabdominal Infections / Q000188:drug therapy*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D015282:Octreotide / Q000008:administration & dosage; D010182:Pancreatic Diseases / Q000188:drug therapy*; D019283:Pancreatitis, Acute Necrotizing / Q000150:complications / Q000188:drug therapy* / Q000601:surgery; D011480:Protease Inhibitors / Q000008:administration & dosage; D012189:Retrospective Studies; D013004:Somatostatin / Q000008:administration & dosage; D013407:Sulbactam / Q000008:administration & dosage; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D011480:Protease Inhibitors; D013004:Somatostatin; D002438:Cefoperazone; D015282:Octreotide; D013407:Sulbactam