gms | German Medical Science

123. Kongress der Deutschen Gesellschaft für Chirurgie

Deutsche Gesellschaft für Chirurgie

02. bis 05.05.2006, Berlin

Therapeutic efficacy of the continuous arterial infusion in the complex management of necrotizing pancreatitis

Meeting Abstract

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  • corresponding author A. Perejaslov - Department of Surgery, Medical University, Lviv, Ukraine
  • S. Chooklin - Department of Surgery, Medical University, Lviv, Ukraine

Deutsche Gesellschaft für Chirurgie. 123. Kongress der Deutschen Gesellschaft für Chirurgie. Berlin, 02.-05.05.2006. Düsseldorf, Köln: German Medical Science; 2006. Doc06dgch4581

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Veröffentlicht: 2. Mai 2006

© 2006 Perejaslov et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen ( Er darf vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.



Einleitung: Microcirculatory deterioration is often observed in patients with severe acute pancreatitis and may determine the insufficient results of intravenous infusion of protease inhibitors and antibiotics. The efficacy of antibiotics is correlated with their concentration at the site of infection and the duration of their presence there. However, continuous intravenous infusion requires high doses to maintain the optimal concentration in tissue, and high doses may be harmful. Thus, continuous arterial infusion may be the best means of obtaining an optimal tissue concentration with minimal toxicity.

Material und Methoden: During 2003-2005 years 114 patients with necrotizing pancreatitis were treated. All of them received the identical conventional treatment that included the adequate pain relief, fluid resuscitation, inhibition of action proinflammatory mediators, and infusion of antibiotics. All patients were divided on two groups: 1st – 42 (36.8%) patients, which received antibiotics, protease inhibitors and pentoxifylline (PTXP) via continuous arterial infusion, 2nd – 72 (63.2%) with routine intravenous infusions. The contamination of necrotic foci was determined using percutaneous CT-guided fine needle aspiration.

Ergebnisse: At the time of admission the Ranson, APACHE II, and Balthazar score was not different in both groups. Contamination of the necrotic focuses was confirmed in 30 (41.7%) patients of the second group and in 7 (16.7%) patients of the first group. Besides that, the further spreading of necrotic process was established in 29 (40.3%) patients of the second group and only in 2 (4.8%) patients of the first group. Intra-arterial infusions permit to decrease zones of necrotic changes in 27 (64.3%) patients and stabilize necrotic process in 13 (30.9%) patients what allow to apply the mini-invasive technique in 15 (37.5%) of them.

Schlussfolgerung: Thus, the continuous arterial infusion stabilized the necrotic changes both in pancreas and peripancreatic areas and obviously decreases the risk of contamination of the necrotic foci.