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Hyperbaric oxygen therapy in the treatment of refractory peripancreatic abscess associated with severe acute pancreatitis

  • Liver, Pancereas, and Biliary Tract
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Summary

Five patients with peripancreatic abscesses associated with severe acute pancreatitis were treated by hyperbaric oxygen therapy (HBO). In 3 patients, the course after surgical mobilization of the pancreas and drainage of the pancreas bed was complicated by peripancreatic abscesses. HBO was conducted under a pressure of 2.8 atmospheres for two hours dialy. Four of the 5 patients showed a progressive improvement in their condition. In one patient who failed to respond despite seven sessions of HBO, Pseudomonas aeruginosa was isolated from the discharge, and resection of necrotic tissue and drainage were performed. The main effects of HBO were the alleviation of high spiking fever, the improvement of white blood cell count and serum amylase levels, and the reduction of the abscess size. We recognized HBO to be a successful treatment for peripancreatic abscess associated with severe acute pancreatitis and better results were obtained than in cases that did not receive HBO.

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References

  1. Warshaw AL, Pancreatic abscesses. N Engl J Med 1972;287:1234–1236.

    Article  PubMed  CAS  Google Scholar 

  2. Donohue PE, Nyhus LM, Baker RJ. Pancreatic abscess after alcoholic pancreatitis. Arch Surg 1980;115:905–909.

    Google Scholar 

  3. Ranson JHC, Spencer FC. Prevention. diagnosis. and treatment of pancreatic abscess. Surgery 1977;82:99–106.

    PubMed  CAS  Google Scholar 

  4. Becker JM, Pemberton JH, DiMagno EP, et al. Prognostic factors in pancreatic abscess. Surgery 1984;96:455–461.

    PubMed  CAS  Google Scholar 

  5. Bradley EL, Fulenwider JT. Open treatment of pancreatic abscess. Surg Gynecol Obstet 1984;159:513.

    Google Scholar 

  6. Warshaw AL, Gongling JIN. Improved survival in 45 patients with pancreatic abscess. Ann Surg 1985;202:408–417.

    PubMed  CAS  Google Scholar 

  7. Paloyan D, Simonowitz D, Bates RJ. Guidelines in the management of patients with pancreatic abscess. Am J Gastroenterol 1978;69:97–100.

    PubMed  CAS  Google Scholar 

  8. Bolooki H, Jaffe Burton, Gliedman ML. Pancreatic abscesses and lesser omental sac collections. Surg Gynecol Obstet 1968;1301-1308.

  9. Davidson ED, Bradley EL. Maruspialization in the treatment of pancreatic abscess. Surgery 1981;89:252–256.

    PubMed  CAS  Google Scholar 

  10. Larvin M, Chalmers AG, Robinson PJ, et al. Debridement and closed cavity irrigation for the treatment of pancreatic necrosis. Br J Surg 1989;76:465–471.

    Article  PubMed  CAS  Google Scholar 

  11. Tsuchiya R, Tsunoda T, Nagae T. Experimental study of hyperbaric oxygen therapy for severe acute pancreatitis. The Report of the Research Committee of Intractable Disease of the Pancreas sponsored by the Japanese Ministry of Health and Welfare 1989;246.

  12. Hamblen DL. Hyperbaric oxygenation. J Bone and Joint Srug 1968;50:1129–1141.

    CAS  Google Scholar 

  13. McRipley RJ, Sbarra AJ. Role of the phagocyte in host-parasite interactions. J Bacteriol 1967;94:1417–1424.

    PubMed  CAS  Google Scholar 

  14. Ranson JH. The role of surgery in the management of acute pancreatitis. Ann Surg 1990;211:382–393.

    PubMed  CAS  Google Scholar 

  15. Warshaw AL, Imbambo AL, Civetta JM, et al. Surgical intervention in acute necrotizing pancreatitis. Am J Surg 1974; 127:484–491.

    Article  PubMed  CAS  Google Scholar 

  16. Miller TA, Lindenauer SM, Frey CF, et al. Pancreatic abscess. Arch Surg 1974;108:545–551.

    PubMed  CAS  Google Scholar 

  17. Kaushik SP, Vohra R, Verma GR, et al. Pancreatic abscess: a review of seventeen cases. Br J Surg 1984;71:141–143.

    Article  PubMed  CAS  Google Scholar 

  18. Bradley EL, Fulenwider JT. Open treatment of pancreatic abscess. Surg. Gynecol Obstet 1984;159:509–513.

    PubMed  Google Scholar 

  19. Berne TV, Donovan AJ. Synchronous anterior celiotomy and posterior drainage of pancreatic abscess. Arch Surg 1981;116:527–533.

    PubMed  CAS  Google Scholar 

  20. Ranson JC, Berman RS. Long peritoneal lavage decreases pancreatic sepsis in acute pancreatitis. Ann Surg 1990;211:708–718.

    Article  PubMed  CAS  Google Scholar 

  21. Pederzoli P, Bassi C, Vasentini S, et al. Retroperitoneal and peritoneal drainage and lavage in the treatment of severe necrotizing pancreatitis. Surgery 1990;127:197–203.

    Google Scholar 

  22. Tsuchiya R, Itoh T, Harada N, et al. Result of mobilization and drainage of the pancreas for acute pancreatitis. Jpn J Surg 1984; 14:198–206.

    Article  PubMed  CAS  Google Scholar 

  23. Mader JT, Guchian JC, Glass DL, et al. Therapy with hyperbaric oxygen for experimental osteomyelitis due to staphylococcus aureus in rabbits. J Infect Dis 1978;138:312–318.

    PubMed  CAS  Google Scholar 

  24. Brummelkamp WH, Hogendijk J, Boerema I. Treatment of anaerobic infections (clostridial myositis) by drenching the tissues with oxygen under high atmospheric pressure. Surgery 1961;49:299–302.

    Google Scholar 

  25. Jacobson JH. Present status of clinical application of hyperbaric medicine. J Jap Society Hyperbaric Environment 1984;19:207–216.

    Google Scholar 

  26. Kopkinson WI, Towes AG. Effects of hyperbaric oxygen on some common pathogenic bacteria. Lancet 1963;28:1361–1363.

    Article  Google Scholar 

  27. Mandell GL. Bactericidal activity of aerobic and anaerobic polymorphonuclear neutrophils. Infec Immunity 1974;9:337–341.

    CAS  Google Scholar 

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Izawa, K., Tsunoda, T., Ura, K. et al. Hyperbaric oxygen therapy in the treatment of refractory peripancreatic abscess associated with severe acute pancreatitis. Gastroenterol Jpn 28, 284–291 (1993). https://doi.org/10.1007/BF02779232

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  • DOI: https://doi.org/10.1007/BF02779232

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