nach oben

Surgery Today

Erschienen in:

01.03.2016 | Original Article

Early-phase peritoneal drainage and lavage in a rat model of severe acute pancreatitis

verfasst von: Leiming Zhu, Jilin Lu, Jing Yang, Peng Sun

Erschienen in: Surgery Today | Ausgabe 3/2016

Einloggen, um Zugang zu erhalten

Abstract

Purpose

To evaluate the effects of early-phase drainage on the survival rates and pancreatic pathological changes associated with severe acute pancreatitis (SAP) in a rat model.

Methods

Sprague–Dawley rats were divided into the following groups: SAP model (control), early drainage and delayed drainage. The 24-h survival rates were compared among the groups. In addition, the serum and ascites concentrations of interleukin (IL)-1β, IL-6, IL-8, IL-10 and tumor necrosis factor (TNF)-α were measured, and pancreatic pathological changes were observed.

Results

The survival rate significantly improved in the early drainage group. Compared with that observed in the control group, the serum TNF-α and IL-8 concentrations in the early drainage group decreased, while the serum IL-10 levels increased, and the ascites concentrations of IL-1β, IL-6, IL-8 and TNF-α decreased, while that of IL-10 increased significantly. In the delayed drainage group, only the ascites concentrations of TNF-α decreased. Meanwhile, the pancreatic pathological changes at 3, 6 and 24 h worsened in the early drainage group; however, the pancreatic lesions in the early drainage group were less mild than those seen in the control group.

Conclusions

Rebalancing the cytokine levels in ascites after early drainage may be a key factor for enhancing the survival rate in rats.

Mole DJ, Olabi B, Robingson V, Garden OJ, Parks RW. Incidence of individual organ dysfunction in fatal acute pancreatitis: analysis of 1024 death records. HBP. 2009;11:166–70.

Fu CY, Yeh CN, Hsu JT, Jan YY, Hwang TL. Timing of mortality in severe acute pancreatitis: experience from 643 patients. World J Gastroenterol. 2007;13:1966–9.PubMedCentralCrossRefPubMed

Sun JK, Li WQ, Ni HB, Ke L, Tong ZH, Li N, et al. Modified gastrointestinal failure score for patients with severe acute pancreatitis. Surg Today. 2013;43:506–13.CrossRefPubMed

Uhl W, Warshaw A, Imrie C, Bassi C, McKay CJ, Lankisch PG, et al. IAP guidelines for the surgical management of acute pancreatitis. Pancreatology. 2002;2:565–73.CrossRefPubMed

Hasibeder WR, Torgersen C, Rieger M, Dünser M. Critical care of the patient with acute pancreatitis. Anaesth Intensive Care. 2009;37:190–206.PubMed

Andersson R, Sward A, Tingstedt B, Akerberg D. Treatment of acute pancreatitis: focus on medical care. Drugs. 2009;69:505–14.CrossRefPubMed

Bakker OJ, Van Santuoort HC, Basselink MGH, Uan der Harst E, Hofker HS, Goozen HG, Dutch Pancreatitis Study Group. Prevention, detection and management of infected necrosis in severe acute pancreatitis. Curr Gastroenterol Rep. 2009;11:104–10.CrossRefPubMed

Nieuwenhuijs VB, Besselink MG, van Minnen LP, Gooszen HG. Surgical management of acute necrotizing pancreatitis: a 13-year experience and a systematic review. Scand J Gastroenterol Suppl. 2003;239:111–6.CrossRefPubMed

Rau B, Bothe A, Beger HG. Surgical treatment of necrotizing pancreatitis by necrosectomy and closed lavage: changing patient characteristics and outcome in a 19-year, single-center series. Surgery. 2005;138:28–39.CrossRefPubMed

10.

De Waele JJ, Hoste E, Blot SI, Hesse U, Pattyn P, de Hemptinne B, et al. Perioperative factors determine outcome after surgery for severe acute pancreatitis. Crit Care. 2004;8:R 504–11.CrossRef

11.

Cheung MT, Li WH, Kwok PC, Hong JK. Surgical management of pancreatic necrosis: towards lesser and later. J Hepatobiliary Pancreat Sci. 2010;17:338–44.CrossRefPubMed

12.

Fotoohi M, Traverso LW. Management of severe pancreatic necrosis. Curr Treat Options Gastroenterol. 2007;10:341–6.CrossRefPubMed

13.

Bruennler T, Hamer OW, Lang S, Gruene S, Wrede CE, Zorger N, et al. Outcome in a large unselected series of patients with acute pancreatitis. Hepatogastroenterology. 2009;56:871–6.PubMed

14.

Runzi M, Niebel W, Goebell H, Gerken G, Layer P. Severe acute pancreatitis: nonsurgical treatment of infected necroses. Pancreas. 2005;30:195–9.CrossRefPubMed

15.

Navalho M, Pires F, Duarte A, Goncalves A, Alexandrino P, Tavora I. Percutaneous drainage of infected pancreatic fluid collections in critically ill patients: correlation with C-reactive protein values. Clin Imaging. 2006;30:114–9.CrossRefPubMed

16.

Ai X, Qian X, Pan W, Xu J, Hu W, Terai T, et al. Ultrasound-guided percutaneous drainage may decrease the mortality of severe acute pancreatitis. J Gastroenterol. 2010;45:77–85.CrossRefPubMed

17.

Mortelé KJ, Girshman J, Szejnfeld D, Ashley SW, Erturk SM, Banks PA, et al. CT-guided percutaneous catheter drainage of acute necrotizing pancreatitis: clinical experience and observations in patients with sterile and infected necrosis. AJR AM J Roentgenol. 2009;192:110–6.CrossRefPubMed

18.

Wig JD, Gupta V, Kochhar R, Doley RP, Yadav TD, Poornachandra KS, et al. The role of non-operative strategies in the management of severe acute pancreatitis. JOP J Pancreas. 2010;11:553–9.

19.

Tenner S, Baillie J, DeWitt J, Vege SS. American College of Gastroenterology guideline: management of acute pancreatitis. Am J Gastroenterol. 2013;108(1400–15):1416.

20.

Dugernier T, Laterre PF, Reynaert MS. Ascites fluid in severe acute pancreatitis: from pathophysiology to therapy. Acta Gastroenterol Belg. 2000;63:264–8.PubMed

21.

Walser EM, Nealon WH, Marroquin S, Raza S, Hernandez JA, Vasek J. Sterile fluid collections in acute pancreatitis: catheter drainage versus simple aspiration. Cardiovasc Interv Radiol. 2006;29:102–7.CrossRef

22.

Segal D, Mortelé KJ, Banks PA, Silverman SG. Acute necrotizing pancreatitis: role of CT-guided percutaneous catheter drainage. Abdom Imaging. 2007;32:351–61.CrossRefPubMed

23.

Kusske AM, Rongione AJ, Ashley SW, Mcfadden DW, Reber HA. Interleukin-10 prevents death in lethal necrotizing pancreatitis in mice. Surgery. 1996;120:284–9.CrossRefPubMed

24.

Babu RY, Gupta R, Kang M, Bhasin DK, Rana SS, Singh R. Predictors of surgery in patients with severe acute pancreatitis managed by the step-up approach. Ann Surg. 2013;257:737–50.CrossRefPubMed

25.

Freeny PC, Hauptmann E, Althaus SJ, Traverso LW, Sinanan M. Percutaneous CT-guided catheter drainage of infected acute necrotizing pancreatitis: techniques and results. Am J Roentgenol. 1998;170:969–75.CrossRef

26.

Tang LJ, Wang T, Cui JF, Zhang BY, Li S, Li DX, et al. Percutaneous catheter drainage in combination with choledochoscope-guided debridement in treatment of peripancreatic infection. World J Gastroenterol. 2010;16:513–7.PubMedCentralCrossRefPubMed

27.

Horvath K, Freeny P, Escallon J, Heagerty P, Comstock B, Glickerman DJ, et al. Safety and efficacy of video-assisted retroperitoneal debridement for infected pancreatic collections: a multicenter, prospective, single-arm phase 2 study. Arch Surg. 2010;145:817–25.CrossRefPubMed

28.

Van Santvoort HC, Bakker OJ, Bollen TL, Besselink MG, Ahmed Ali U, Schrijver AM, Dutch Pancreatitis Study Group, et al. A conservative and minimally invasive approach to necrotizing pancreatitis improves outcome. Gastroenterology. 2011;141:1254–63.CrossRefPubMed

29.

Van Santvoort HC, Besselink MG, Bakker OJ, Hofker HS, Boermeester MA, Dejong CH, Dutch Pancreatitis Study Group, et al. A step-up approach or open necrosectomy for necrotizing pancreatitis. N Engl J Med. 2010;362:1491–502.CrossRefPubMed

30.

Matsumoto K, Miyake Y, Nakatsu M, Toyokawa T, Ando M, Hirohata M, et al. Usefulness of early-phase peritoneal lavage for treating severe acute pancreatitis. Intern Med. 2014;53:1–6.CrossRefPubMed

31.

Zhang XP, Zhang J, Ma ML, Cai Y, Xu RJ, Xie Q, et al. Pathological changes at early stage of multiple organ injury in a rat model of severe acute pancreatitis. Hepatobiliary Pancreat Dis Int. 2010;9:83–7.PubMed

32.

Rau B, Bothe A, Kron M, Beger HG. Role of early multisystem organ failure as major risk factor for pancreatic infections and death in severe acute pancreatitis. Clin Gastroenterol Hepatol. 2006;4:1053–61.CrossRefPubMed

33.

Andersson R, Andersson B, Andersson E, Axelsson J, Eckerwall G, Tingstedt B. Acute pancreatitis-from cellular signaling to complicated clinical course. HBP. 2007;9:414–20.

34.

Granger J, Remick D. Acute pancreatitis: models, markers and mediators. Shock. 2005;24(Suppl 1):45–51.CrossRefPubMed

35.

Shen Y, Deng X, Xu N, Li Y, Miao B, Cui N. Relationship between the degree of severe acute pancreatitis and patient immunity. Surg Today. 2014;. doi:10.1007/s00595-014-1083-1.

36.

Norman JG, Fink GW, Denham W, Yang J, Carter G, Sexton C, et al. Tissue-specific cytokine production during experimental acute pancreatitis. A probable mechanism for distant organ dysfunction. Dig Dis Sci. 1997;42:1783–8.CrossRefPubMed

37.

Mayer J, Rau B, Gansauge F, Beger HG. Inflammatory mediators in human acute pancreatitis: clinical and pathophysiological implications. Gut. 2000;47:546–52.PubMedCentralCrossRefPubMed

38.

Stimac D, Fisić E, Milić S, Bilić-Zulle L, Perić R. Prognostic values of IL-6, IL-8, and IL-10 in acute pancreatitis. J Clin Gastroenterol. 2006;40:209–12.CrossRefPubMed

39.

Souza LJ, Coelho AM, Sampietre SN, Martins JO, Cunha JE, Machado MC. Anti-inflammatory effects of peritoneal lavage in acute pancreatitis. Pancreas. 2010;39:1180–4.CrossRefPubMed

40.

Sugimoto M, Takada T, Yasuda H, Nagashima I, Amano H, Yoshida M, et al. The lethal toxicity of pancreatic ascites fluid in severe acute necrotizing pancreatitis. Hepatogastroenterology. 2006;53:442–6.PubMed

41.

Lundberg AH, Eubanks JW 3rd, Henry J, Sabek O, Kotb M, Gaber L, et al. Trypsin stimulates production of cytokines from peritoneal macrophages in vitro and in vivo. Pancreas. 2000;21:41–51.CrossRefPubMed

42.

Solanki R, Thumma V, Sastry RA, Bheerappa N. The role of image guided percutaneous drainage in multidisciplinary management of necrotizing pancreatitis. Trop Gastroenterol. 2013;34:25–30.CrossRefPubMed

43.

Xu W, Roos A, Schlagwein N, Woltman AM, Daha MR, van Kooten C. Il-10-producing macrophages preferentially clear early apoptotic cells. Blood. 2006;107:4930–7.CrossRefPubMed

44.

Xu W, Schlagwein N, Roos A, van den Berg TK, Daha MR, van Kooten C. Human peritoneal macrophages show functional characteristics of M-CSF-driven anti-inflammatory type 2 macrophages. Eur J Immunol. 2007;37:1594–9.CrossRefPubMed

45.

Rongione AJ, Kusske AM, Reber HA, Ashley SW, McFadden DW. Interleukin-10 reduces circulating levels of serum cytokines in experimental pancreatitis. J Gastrointest Surg. 1997;1:159–66.CrossRefPubMed

46.

Fric P, Slabý J, Kasafírek E, Kocna P, Marek J. Effective peritoneal therapy of acute pancreatitis in the rat with glutaryl-trialanin-ethylamide: a novel inhibitor of pancreatic elastase. Gut. 1992;33:701–6.PubMedCentralCrossRefPubMed

Titel: Early-phase peritoneal drainage and lavage in a rat model of severe acute pancreatitis
verfasst von: Leiming Zhu
Jilin Lu
Jing Yang
Peng Sun
Publikationsdatum: 01.03.2016
Verlag: Springer Japan
Erschienen in: Surgery Today / Ausgabe 3/2016
Print ISSN: 0941-1291
Elektronische ISSN: 1436-2813
DOI: https://doi.org/10.1007/s00595-015-1172-9

Leitlinien kompakt für die Allgemeinmedizin

Mit medbee Pocketcards sicher entscheiden.

^{Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag}

Kostenlos registrieren

Facharzt-Training Allgemeinmedizin

Die ideale Vorbereitung zur anstehenden Prüfung mit den ersten 24 von 100 klinischen Fallbeispielen verschiedener Themenfelder

Mehr erfahren

Neu im Fachgebiet Allgemeinmedizin

25.04.2024 | Hypotonie | Nachrichten

Update Allgemeinmedizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Springer Medizin

Early-phase peritoneal drainage and lavage in a rat model of severe acute pancreatitis

Abstract

Purpose

Methods

Results

Conclusions

Leitlinien kompakt für die Allgemeinmedizin

Facharzt-Training Allgemeinmedizin

Neu im Fachgebiet Allgemeinmedizin

Niedriger diastolischer Blutdruck erhöht Risiko für schwere kardiovaskuläre Komplikationen

Therapiestart mit Blutdrucksenkern erhöht Frakturrisiko

Metformin rückt in den Hintergrund

Myokarditis nach Infekt – Richtig schwierig wird es bei Profisportlern

Update Allgemeinmedizin

Springer Medizin

Abstract

Purpose

Methods

Results

Conclusions

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 3/2016

Reconstruction using a divided latissimus dorsi muscle flap after conventional posterolateral thoracotomy and the effectiveness of indocyanine green-fluorescence angiography to assess intraoperative blood flow

Proteomic analysis in cardiovascular research

Current status of and perspectives regarding neoadjuvant chemoradiotherapy for locally advanced esophageal squamous cell carcinoma

Emergent laparoscopic cholecystectomy for acute acalculous cholecystitis revisited

Which prosthesis is more resistant to vascular graft infection: polytetrafluoroethylene or Omniflow II biosynthetic grafts?

Significance of the mucinous component in the histopathological classification of colon cancer

Leitlinien kompakt für die Allgemeinmedizin

Facharzt-Training Allgemeinmedizin

Neu im Fachgebiet Allgemeinmedizin

Niedriger diastolischer Blutdruck erhöht Risiko für schwere kardiovaskuläre Komplikationen

Therapiestart mit Blutdrucksenkern erhöht Frakturrisiko

Metformin rückt in den Hintergrund

Myokarditis nach Infekt – Richtig schwierig wird es bei Profisportlern

Update Allgemeinmedizin