Endoscopic Peritoneal Lavage And Drainage In The Treatment Of Intra-abdominal Hypertension Or Abdominal Compartment Syndrome Complicated By Severe Acute Pancreatitis

Objective：To determine the feasibility, clinical value and technical features of endoscopicperitoneal lavage and drainage in the treatment of intra-abdominal hypertension orabdominal compartment syndrome complicated by severe acute pancreatitis.Methods: Endoscopic peritoneal lavage and drainage was performed for22patients withintra-abdominal hypertension or abdominal compartment syndrome complicated by severeacute pancreatitis. and abdominal operation was performed for11patients withintra-abdominal hypertension or abdominal compartment syndrome complicated by severeacute pancreatitis.The duration of enteroplegia and intra-abdominal hypertension, APACHEII score, levels of testing items in serum and ascites/peritoneal drainage fluid,operation time,hospital stay and cost and complications were evaluated.Results：In22patients who had endoscopic peritoneal lavage and drainage, the time ofperitoneal lavage and drainage duration was (6.55±2.74) days. recovery time of19patientswho had enteroplegia was (3.45±1.06) days and the levels of total protein, nucleated cellcount, amylase in ascites/peritoneal drainage fluid were decreased significantly duringperitoneal lavage and dialysis. The cure rate was90.9%(20/22),2patients(9.1％) weretransferred to the surgery, and the mortality was4.5%（1/22）.The cure rate of11patients whohad laparotomy was72.7%（8/11）, and the mortality was27.3%（3/11）.The serumamylase activity, APACHE II score and levels of IAP and CRP after the treatment weresignificantly lower than those before the treatment (P <0.05).Conclusion：Endoscopic peritoneal lavage and drainage in the early treatment ofintra-abdominal hypertension or abdominal compartment syndrome complicated by severeacute pancreatitis is safe, effective and minimal invasive method.