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.
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References
Wall AJ (1965) Peritoneal dialysis in the treatment of severe acute pancreatitis. Med J Aust 2:281–283
Gjessing J (1967) Peritoneal dialysis in severe acute hemorrhagic pancreatitis. Acta Chir Scand 133:645
Bolooki H, Gliedman NL (1968) Peritoneal dialysis in treatment of acute pancreatitis. Surgery 64:466–471
Geokas MC, Rinderknecht H, Brodrick JW, Largman C (1978) Studies on the ascites fluid of acute pancreatitis in man. Am J Dig Dis 23:182–188
Lasson A, Ohlsson K (1984) Peritoneal lavage in severe acute pancreatitis. Scand J Gastroenterol 19 [Suppl 99]:6
Ranson JHC, Spencer FC (1978) The role of peritoneal lavage in severe acute pancreatitis. Ann Surg 187:565–576
Mayer AD, McMahon MJ, Corfield AP, Cooper MJ, Williamson RC, Dickson AP (1985) Controlled clical trial of peritoneal lavage in for the treatment of severe acute pancreatitis. N Engl J Med 312:339–404
Schroder T, Sainio V, Kivisaari L, Puolakkainen P, Kivilaakso E, Lempinen M (1991) Pancreatic resection vs peritoneal lavage in acute necrotizing pancreatitis: A prospective randomized trial. Ann Surg 14:663–666
Ranson JHC, Berman RS (1990) Long peritoneal lavage decreased pancreatic sepsis in acute pancreatitis. Ann Surg 211:708–716
Stone HH, Fabian TC (1980) Peritoneal dialysis in the treatment of alcoholic pancreatitis. Surg Gynecol Obstet 150:878–882
Satake K, Koh I, Nishiwaki H, Umeyama K (1985) Toxic products in hemorrhagic ascitic fluid generated experimental acute hemorrhagic pancreatitis in dogs and a treatment which recuced their effect. Digestion 32:99–105
Hiura A, Satake K, Nishiwaki H, Chung YS, Umeyama K (1990) A new attempt at treatment of acute pancreatitis. The effect of peritoneal lavage with pancreatic protease inhibitor (in Japanese with English abstract). J Bil Tract Pancreas 11:287–291
Fujita S, Teraoka S, Ota K (1990) Peritoneal lavage for severe acute pancreatitis (in Japanese with English abstract). Jpn J Clin Med 48:173–180
Zanen S, Brand A, Cats A (1983) Acute pancreatitis in SLE, successful treatment with plasmapheresis after failure of predinine. Clin Exp Rheumatol 1:341–344
Ossi F, Fiocero U, Belloni, Ongaro G, Rubaltelli L, Ruffatti A, Fodisco S (1983) Therapy of acute pancreatitis in SLE with plasmapheresis and corticosteroids. Clin Exp Rheumatol 1:345–347
Yamauchi H, Takeda K, Sunamura M, Miyagawa K (1985) Plasma exchange as a therapeutic intervention in severe acute pancreatitis (in Japanese with English abstract). J Bil Tract Pancreas 6:635–640
Ohashi O (1987) Experimental study of the effectiveness of plasma exchange for severe acute pancreatitis (in Japanese with English abstract). Med J Kobe Univ 48:105–111
Health D, Imrie CW, Garrett JA, Shearer MG, Hogs RB, Hughes RL (1988) Plasmapheresis and fulminant acute pancreatitis. BMJ 297:979–980
Matsuno S, Takeda K (1988) Plasma purification therapy for patient with acute pancreatitis (in Japanese with English abstract). Jpn J Acute Med 12:1729–1734
Larvin M, Lansdown MRJ, McMahon MJ, Chalmers AG, Turney JH, Brownjohn AM (1988) Plasmapheresis: A rational treatment for fulminant acute pancreatitis. BMJ 297:593–594
Hosotani R, Yamasaka K, Aoyama H (1990) Operative indications and plasma exchange in the treatment of acute severe pancreatitis. Abstrs Int Assoc Pancreatol IV-89
Begar HG, Buchler M, Bittner R, Oettinger W, Block S, Nevalainen T (1988) Necrosectomy and postoperative local lavage in patients with necrotizing pancreatitis: Results of a prospective clinical trial. World J Surg 12:252–262
Shiga H, Hirasawa H (1993) Acute plasma purification — plasma exchange (in Japanese). Intensive Crit Care Med 5:639–646
Members of the American College of Chest Physicians/Society of Critical Care Medicine Consensus Conference Committee (1992) Dennitions of sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. Crit Care Med 20:864–874
Hirasawa H, Sugai K, Otake Y, Oda S (1994) SIRS and sepsis. A new concept of sepsis (in Japanese). Intensive Crit Care Med 6:105–114
Steinberg W, Tenner S (1994) Acute pancreatitis. N Engl J Med 330:1198–1210
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Hiura, A., Satake, K. Evaluation of specific treatment for severe acute pancreatitis based on the results of the cooperative national survey in Japan. J Hep Bil Pancr Surg 3, 227–233 (1996). https://doi.org/10.1007/BF02391020
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DOI: https://doi.org/10.1007/BF02391020