Combined effect of ultrasound-guided percutaneous abdominal paracentesis drainage and ulinastatin on severe acute pancreatitis

Chuanmin Liu,Fei Yuan,Xuezhen Wang,Baowei Wang

doi:10.4314/tjpr.v20i10.24

Abstract

Purpose: To study the clinical effect of a combination of ultrasound-guided percutaneous abdominal paracentesis drainage (APD) and ulinastatin on severe acute pancreatitis (AP).Methods: A total of 94 patients with severe AP in Intensive Care Unit, Jiaozhou Central Hospital, Qingdao, from December 2017 to December 2018 were selected as the research subjects. They were divided into control and study groups, with 47 patients in each group. Patients in the control group underwent laparotomy drainage, while patients in the study group underwent ultrasound-guidedpercutaneous APD. Patients in both groups received ulinastatin perfusion. Subsequently, clinical effectsand other relevant indicators were determined.Results: Overall response was significantly higher in the study group than in the control group (p < 0.05). The times taken for disappearance of postoperative symptoms, normalization of serum amylase level, and hospitalization were significantly shorter in the study group than in the control group (p < 0.05). For every indicator, the study group exhibited more benefits after than before treatment; however, post-treatment levels of blood glucose, hemodiastase and urinary amylase were better than those in the control group (p < 0.05). Incidence of postoperative complications was lower in the study group than in control group (p < 0.05).Conclusion: The combination of ultrasound-guided percutaneous APD with ulinastatin produces marked beneficial effects on severe AP patients. It facilitates the remission of adverse symptoms, and enhances normalization of indicator levels. Moreover, it displays low incidence of complications, better prognosis and recovery, and absence of post-operation infections.

Highlights

Acute pancreatitis (AP) is a frequently reported acute abdominal condition in which the activation of pancreatic enzymes due to certain factors triggers self-digestion, hemorrhage, edema or necrosis of the pancreatic tissue
Total response was significantly higher in the study group than in the control group (p < 0.05; Table 1)
Treatment efficacy was deemed significant if adverse symptoms disappeared

Summary

Introduction

Acute pancreatitis (AP) is a frequently reported acute abdominal condition in which the activation of pancreatic enzymes due to certain factors triggers self-digestion, hemorrhage, edema or necrosis of the pancreatic tissue. It presents mainly as localized inflammation of the pancreas, with or without functional impairment of other organs [1,2,3,4]. About 10% of patients develop severe AP, known as acute hemorrhagic necrotizing pancreatitis (AHNP), which is non-reversible and requires surgical treatment. Mild pancreatitis leads to severe AP if not treated in time [5,6,7]

Methods

Results

Conclusion