A team from Japan evaluated the usefulness of continuous regional arterial infusion (CRAI) of protease inhibitors and antibiotics, in patients with acute necrotizing pancreatitis (ANP).
156 patients were enrolled in the study. All were collected in a cooperative survey carried out in 1997, in Japan.
The researchers found that the overall mortality rate was 19%, and the frequency of infected pancreatic necrosis was 13%.
The patients were divided into two groups. Group A received the protease inhibitor via CRAI and the antibiotics intravenously. Group B received both the protease inhibitor and the antibiotics via CRAI.
|Arterial protease inhibitors and antibiotics reduce mortality from acute necrotizing pancreatitis.
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There was no significant difference in mortality rates between the two groups. However, the frequency of infected pancreatic necrosis was significantly lower in group B (8%) than in group A (24%).
The mortality rate in patients, in whom CRAI therapy was initiated within 48 hours after the onset of ANP, was 12%. This was significantly lower than that in patients in whom therapy was initiated more than 48 hours after onset (24%).
Kazunori Takeda, of the Tohoku University School of Medicine, concluded on behalf of the authors, "These results suggest that CRAI of both protease inhibitors and antibiotics is effective in reducing mortality and preventing the development of pancreatic infection in ANP, when initiated within 48 hour after the onset of ANP."