Evaluation of specific treatment for severe acute pancreatitis based on the results of the cooperative national survey in Japan

Abstract

A cooperative national survey on acute pancreatitis in Japan was conducted by the Research Committee for Intractable Diseases of the Pancreas. Between January 1952 and December 1986, 2533 cases of acute pancreatitis, including 1219 severe and 1285 moderate cases, diagnosed according to the criteria of the Ministry of Health and Welfare of Japan, were collected from 523 institutions. Peritoneal lavage, plasma exchange, and artifical kidney therapy, that is, hemodialysis and hemofiltration, were employed as specific treatments for severe acute pancreatitis. We have attempted to evaluate the efficacy of these treatments based on the results of this survey. Peritoneal lavage, employed to treat 57 patients, was effective when performed within 3 days of the onset of symptoms and more than six times a day. Plasma exchange, employed in 20 patients, was effective when performed within 5 days of the onset of symptoms. Artificial kidney therapy, performed in 76 patients, was effective when continued for more than 7 days. These findings suggest that accurate and rapid diagnosis, and intensive care to maintain the cardiovascular system are crucial if these specific treatments for severe acute pancreatitis, are to succeed.