The Value Of Ultrasund-guided Tube Lavage And Drainage In Early Treatment For Severe Acute Pancreatitis

ObjectiveSevere acute pancreatitis (SAP) is a common clinical acute abdomen disease with several complications and high mortality. The majority of patients with SAP died of early multi-organ dysfunction syndrome (MODS). There are several factors which play an important role in the evolution of the SAP, such as a number of peritoneal fluid and harmful substances from pancreatitis. This study is designed to clean up the peritoneal exudate of inflammatory mediators in the early SAP, and to discuss the value of minimal invasive treatment on severe acute Panereatitis at an early stage by ultrasound-guided catheter drainage and lavage.Materials and Methods56 patients with severe acute pancreatitis from Shandong Provincial Hospital from September in 2008 to February in 2010 were randomly divided into two groups which were treated with ultrasonic-guided percutaneous catheter drainage and lavage (n=27 cases) and conservative methods (n=29 cases) respectively. In the former group, besides non-surgical treatment,6 cases were treated bedside in the wards with ultrasound-guided therapy; 12 cases were treated in the ultrasound intervention room; the rest cases were in the CT room with ultrasound and CT guided.29 cases of the latter group patients only received conventional conservative treatment. Laboratory data of both groups were obtained before and after treatment; recovery, efficacy after treatment and mortality were compared between these two groups; medical statistics analysis were made.Results(1) There were not statistically significant differences in gender, age, etiology and so on between these two groups (P> 0.05). (2) 27 patients of the intervention treatment group were successfully treated. The treatment time was about 40-90 minutes and 4-9 drainage tubes were placed. Postoperative lavage Time was 7-22 days. After the success of tube drainage, bloody or thick fluid could be drainaged out. No severe complications happened.(3) After treatment, the levels of amylase in blood and urine and leukocyte in intervention treatment group declined sharply; the level of calcium in blood rised. Besides, there were significant differences (P<0.01) in the time of relief from abdominal pain, duration, etc between these two groups. The incidence of mortality in intervention treatment group was significantly lower than the conservative treatment group. At the same time the cure rate of the former is higher than the latter.ConclusionsUltrasound-guided tube drainage and lavage treatment can relieve symptoms in patients with SAP, slow down and block the progression of the disease, improve the cure rate and the prognosis of patients with SAP, reduce the incidence of complications and mortality and shorten the course. In a word, Ultrasound tube drainage and lavage treatment is more effective than conservative treatment for clinical treatment of severe acute pancreatitis and provide more choices for its treatment.