Brief Article
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World J Gastroenterol. Dec 14, 2013; 19(46): 8752-8757
Published online Dec 14, 2013. doi: 10.3748/wjg.v19.i46.8752
Perirenal space blocking restores gastrointestinal function in patients with severe acute pancreatitis
Jun-Jun Sun, Zhi-Jie Chu, Wei-Feng Liu, Shi-Fang Qi, Yan-Hui Yang, Peng-Lei Ge, Xiao-Hui Zhang, Wen-Sheng Li, Cheng Yang, Yu-Ming Zhang
Jun-Jun Sun, Zhi-Jie Chu, Wei-Feng Liu, Shi-Fang Qi, Yan-Hui Yang, Peng-Lei Ge, Xiao-Hui Zhang, Wen-Sheng Li, Cheng Yang, Yu-Ming Zhang, Department of General Surgery, the First Affiliated Hospital of Henan University of Science and Technology, Luoyang 471003, Henan Province, China
Author contributions: Sun JJ designed the research; Chu ZJ, Liu WF and Qi SF performed the research; Yang YH, Ge PL and Zhang XH contributed new reagents or analytic tools; Li WS, Yang C and Zhang YM analyzed the data; Sun JJ and Chu ZJ wrote the paper.
Correspondence to: Jun-Jun Sun, Professor, Department of General Surgery, the First Affiliated Hospital of Henan University of Science and Technology, No. 24 JingHua Road, Luoyang 471003, Henan Province, China. junjunsuncn@126.com
Telephone: +86-379-64830650 Fax: +86-379-64830602
Received: May 29, 2013
Revised: October 21, 2013
Accepted: November 3, 2013
Published online: December 14, 2013
Processing time: 203 Days and 0.7 Hours
Abstract

AIM: To investigate effects of perirenal space blocking (PSB) on gastrointestinal function in patients with severe acute pancreatitis (SAP).

METHODS: Forty patients with SAP were randomly allocated to receive PSB or no PSB (NPSB). All the SAP patients received specialized medical therapy (SMT). Patients in the PSB group received PSB + SMT when hospitalized and after diagnosis, whereas patients in the NPSB group only received SMT. A modified gastrointestinal failure (GIF) scoring system was used to assess the gastrointestinal function in SAP patients after admission. Pain severity (visual analog scale, 0 to 100) was monitored every 24 h for 72 h.

RESULTS: Modified GIF score decreased in both groups during the 10-d study period. The median score decrease was initially significantly greater in the PSB group than in the NPSB group after PSB was performed. During the 72-h study period, pain intensity decreased in both groups. The median pain decrease was significantly greater in the PSB group than in the NPSB group at single time points. Patients in the PSB group had significantly lower incidences of hospital mortality, multiple organ dysfunction syndrome, systemic inflammatory response syndrome, and pancreatic infection, and stayed in the intensive care unit for a shorter duration. However, no difference in terms of operation incidence was found between the two groups.

CONCLUSION: PSB could ameliorate gastrointestinal dysfunction or failure during the early stage of SAP. Moreover, PSB administration could improve prognosis and decrease the mortality of SAP patients.

Keywords: Perirenal space blocking; Therapeutics; Severe acute pancreatitis; Gastrointestinal function; Prognosis

Core tip: This work aims to investigate the effects of perirenal space blocking (PSB) on the gastrointestinal function and clinical outcome of patients with severe acute pancreatitis (SAP). Our results showed that PSB could commendably improve the gastrointestinal dysfunction or failure during the early stage of severe SAP. Moreover, PSB administration could improve prognosis and significantly decrease the hospital mortality of SAP patients.