scholarly journals CONTINUOUS REGIONAL ARTERIAL INFUSION FOR THE MANAGEMENT OF PANCREATIC NECROSIS

2019 ◽  
Author(s):  
N.P. Shiryaev ◽  
A.N. Khorev ◽  
D.A. Blagov ◽  
A.V. Plyuta ◽  
E.V. Ablyaev ◽  
...  
Keyword(s):  
Pancreatic Necrosis ◽  
Arterial Infusion ◽  
Continuous Regional Arterial Infusion

scholarly journals Continuous regional arterial infusion versus intravenous administration of the protease inhibitor nafamostat mesilate for predicted severe acute pancreatitis: a multicenter, randomized, open-label, phase 2 trial

2019 ◽  
Vol 55 (3) ◽  
pp. 342-352 ◽  
Author(s):  
Morihisa Hirota ◽  
Tooru Shimosegawa ◽  
Katsuya Kitamura ◽  
Kazunori Takeda ◽  
Yoshifumi Takeyama ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Protease Inhibitor ◽  
Severe Acute Pancreatitis ◽  
Analgesic Effect ◽  
Pancreatic Necrosis ◽  
Controlled Trial ◽  
Nafamostat Mesilate ◽  
Open Label ◽  
Arterial Infusion ◽  
Continuous Regional Arterial Infusion

Abstract Background Continuous regional arterial infusion (CRAI) of protease inhibitor nafamostat mesilate (NM) is used in the context of predicted severe acute pancreatitis (SAP) to prevent the development of pancreatic necrosis. Although this therapy is well known in Japan, its efficacy and safety remain unclear. Methods This investigator-initiated and -driven, multicenter, open-label, randomized, controlled trial (UMIN000020868) enrolled 39 patients with predicted SAP and low enhancement of the pancreatic parenchyma on computed tomography (CT). Twenty patients were assigned to the CRAI group, while 19 served as controls and were administered NM at the same dose intravenously (IV group). The primary endpoint was the development of pancreatic necrosis as determined by CT on Day 14, judged by blinded central review. Results There was no difference between the CRAI and IV groups regarding the percentages of participants who developed pancreatic necrosis (more than 1/3 of the pancreas: 25.0%, range 8.7–49.1% vs. 15.8%, range 3.4–39.6%, respectively, P = 0.694; more than 2/3 of the pancreas: 20%, range 5.7–43.7% vs. 5.3%, range 0.1–26.0%, respectively, P = 0.341). The early analgesic effect was evaluated based on 24-h cumulative fentanyl consumption and additional administration by intravenous patient-controlled analgesia. The results showed that the CRAI group used significantly less analgesic. There were two adverse events related to CRAI, namely bleeding and splenic infarction. Conclusions CRAI with NM did not inhibit the development of pancreatic necrosis although early analgesic effect of CRAI was superior to that of IV. Less-invasive IV therapy can be considered a viable alternative to CRAI therapy.

T1736 Indication for Special Therapies in Acute Pancreatitis: Optimum Severity Score for Continuous Regional Arterial Infusion and Enteral Nutrition

2008 ◽  
Vol 134 (4) ◽  
pp. A-887
Author(s):  
Takashi Ueda ◽  
Yoshifumi Takeyama ◽  
Takeo Yasuda ◽  
Makoto Shinzeki ◽  
Hidehiro Sawa ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Enteral Nutrition ◽  
Severity Score ◽  
Arterial Infusion ◽  
Continuous Regional Arterial Infusion

scholarly journals MODERN POSSIBILITIES OF INTERVENTION RADIOLOGY IN THE TREATMENT OF ACUTE PANCREATITIS AND ITS COMPLICATIONS (literature review)

2017 ◽  
pp. 4-9
Author(s):  
V. M. Mayorov ◽  
Z. A. Dundarov
Keyword(s):  
Pancreatic Necrosis ◽  
Inflammatory Diseases ◽  
Celiac Trunk ◽  
Arterial Infusion ◽  
Chronic Inflammatory Diseases ◽  
Severe Pancreatitis ◽  
The World ◽  
Percutaneous Punctures ◽  
Surgical Tactics ◽  
Omental Bursa

Wide use of interventional radiology methods is one of the promising trends in the improvement of the treatment of patients with severe pancreatitis. The minimally invasive interferences carried out under beam rider guidance, such as percutaneous punctures and percutaneous drainage, endovascular hemostasis and endovascular catheterization of celiac trunk, are effective at all stages of the course of severe pancreatitis, and make it possible to avoid open operational interference in 40-90 % cases and to decrease mortality up to 8-9 %. The article presents the review of national and foreign publications dealing with controversial questions of surgical tactics in sharp liquid formations of the pancreas and omental bursa, effectiveness of the use of percutaneous draining operational interference in infected pancreatic necrosis and parapancreatitis. The world experience of endovascular stoppage of major haemorrhagic complications in patients with acute and chronic inflammatory diseases of the pancreas has been summarized. Questions of the selective intra-arterial infusion of medicines in severe pancreatitis have been studied.

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