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©2008 The WJG Press and Baishideng. All rights reserved.
World J Gastroenterol. Nov 7, 2008; 14(41): 6382-6387
Published online Nov 7, 2008. doi: 10.3748/wjg.14.6382
Continuous regional arterial infusion therapy with gabexate mesilate for severe acute pancreatitis
Yoshifumi Ino, Yoshiyuki Arita, Tetsuro Akashi, Toshinari Kimura, Hisato Igarashi, Takamasa Oono, Masayuki Furukawa, Ken Kawabe, Keiichiro Ogoshi, Jiro Ouchi, Toshihiko Miyahara, Ryoichi Takayanagi, Tetsuhide Ito
Yoshifumi Ino, Yoshiyuki Arita, Hisato Igarashi, Takamasa Oono, Masayuki Furukawa, Ken Kawabe, Ryoichi Takayanagi, Tetsuhide Ito, Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan
Tetsuro Akashi, Department of Gastroenterology, Saiseikai Fukuoka General Hospital, Fukuoka 812-8582, Japan
Yoshifumi Ino, Toshinari Kimura, Masayuki Furukawa, Department of Social Insurance, Nakabaru Hospital, Fukuoka 812-8582, Japan
Keiichiro Ogoshi, Department of Gastroenterology, Fukuoka Higashi Medical Center, Fukuoka 812-8582, Japan
Jiro Ouchi, Division of Gastroenterology, National Kyushu Cancer Center, Fukuoka 812-8582, Japan
Toshihiko Miyahara, National Hospital Organization, Kyushu Medical Center, Fukuoka 812-8582, Japan
Author contributions: Ino Y, Arita Y, Akashi T, Kimura T, Oono T, Furukawa M, Kawabe K, Ogoshi K, Ouchi J, Miyahara T and Ito T performed research; Ino Y, Arita Y, Igarashi H, Ito T, and Takayanagi R analyzed data; Ito T and Arita Y wrote the paper.
Supported by Grant from the Ministry of Education, Culture, Sports, Science, and Technology, Japan, No. 20590808; The Research Committee of Intractable Diseases of the Pancreas, provided by the Ministry of Health, Labour, and Welfare Japan, No. 50253448
Correspondence to: Tetsuhide Ito, MD, PhD, Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan.
itopapa@intmed3.med.kyushu-u.ac.jp
Telephone: +81-92-6425285 Fax: +81-92-6425287
Received: June 16, 2008
Revised: July 19, 2008
Accepted: July 26, 2008
Published online: November 7, 2008
AIM: To evaluate the efficacy of continuous regional arterial infusion therapy (CRAI) with gabexate mesilate and antibiotics for severe acute pancreatitis (SAP).
METHODS: We conducted a prospective study on patients who developed SAP with or without CRAI. Out of 18 patients fulfilled clinical diagnostic criteria for SAP in Japan, 9 patients underwent CRAI, while 9 patients underwent conventional systemic protease inhibitor and antibiotics therapy (non-CRAI). CRAI was initiated within 72 h of the onset of pancreatitis. Gabexate mesilate (2400 mg/d) was continuously administered for 3 to 5 d. The clinical outcome including serum inflammation-related parameters were examined.
RESULTS: The duration of abdominal pain in the CRAI group was 1.9 ± 0.26 d, whereas that in the non-CRAI group was 4.3 ± 0.50. The duration of SIRS in the CRAI group was 2.2 ± 0.22 d, whereas that in the non-CRAI group was 3.2 ± 0.28. Abdominal pain and SIRS disappeared significantly in a short period of time after the initiation of CRAI using gabexate mesilate. The average length of hospitalization significantly differed between the CRAI and non-CRAI groups, 53.3 ± 7.9 d and 87.4 ± 13.9 d, respectively. During the first two weeks, levels of serum CRP and the IL6/IL10 ratio in the CRAI group tended to have a rapid decrease compared to those in the non-CRAI group.
CONCLUSION: The present results suggest that CRAI using gabexate mesilate was effective against SAP.
