Therapeutic effects of continuous intraarterial antibiotic infusion in preventing pancreatic infection in experimental acute necrotizing pancreatitis

被引:28
作者
Hayashi, J
Kawarada, Y
Isaji, S
Yokoi, H
Higashiguchi, T
机构
[1] First Department of Surgery, Mie University, School of Medicine, Tsu, Mie
[2] First Department of Surgery, Mie University, School of Medicine, Tsu, Mie 514
关键词
bacterial translocation; endotoxin; amidase; trypsin; phospholipase A(2);
D O I
10.1097/00006676-199608000-00010
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
To determine the efficacy of antibiotics in the prevention of pancreatic infection and the process of aggravation after induction of acute pancreatitis, antibiotic was administrated intravenously or intraarterially, starting 6 h after acute pancreatitis was induced in dogs by injecting autologous gallbladder bile into the main pancreatic duct. Flomoxef, recognized as an antibiotic able to penetrate well into pancreas tissue, was selected for the present study. Animals were divided into three groups: no antibiotic given (Group A), antibiotic given intravenously as a bolus injection of 25 mg/kg every 6 h (Group B), and antibiotic infused continuously into the celiac trunk (4 mg/kg/h) (Group C). Compared with Group A, continuous intraarterial infusion of antibiotic (Group C) significantly improved the survival rate and decreased the serum levels of phospholipase A(2)(PLA(2)) activity and endotoxin. Furthermore, it completely prevented the occurrence of pancreatic infection, not only ameliorating the severity of pancreatic necrosis but also reducing the activity levels of amidase, trypsin-like enzyme, and PLA(2) in pancreas tissue. Group B showed little beneficial effect. Antibiotic concentration in peripheral blood and pancreas tissue was significantly higher in Group C than in Group B. These results suggest that continuous arterial infusion of antibiotics into the feeding artery of the pancreas is an effective modality for preventing pancreatic infection aggravation of severe acute pancreatitis.
引用
收藏
页码:184 / 192
页数:9
相关论文
共 32 条
[11]  
KODESCH R, 1973, SURG GYNECOL OBSTET, V136, P763
[12]  
LANGE JF, 1987, HEPATO-GASTROENTEROL, V34, P28
[13]  
LOWRY OH, 1951, J BIOL CHEM, V193, P265
[14]   FACTORS CONTRIBUTING TO FATAL OUTCOME AFTER TREATMENT OF PANCREATIC-ABSCESS [J].
MALANGONI, MA ;
SHALLCROSS, JC ;
SEILER, JG ;
RICHARDSON, JD ;
POLK, HC .
ANNALS OF SURGERY, 1986, 203 (06) :605-613
[15]   PATHOGENESIS OF PANCREATIC SEPSIS [J].
MEDICH, DS ;
LEE, TK ;
MELHEM, MF ;
ROWE, MI ;
SCHRAUT, WH ;
LEE, KKW .
AMERICAN JOURNAL OF SURGERY, 1993, 165 (01) :46-52
[16]  
MIZOJIRI K, 1987, CHEMOTHERAPY, V35, P176
[17]   PURIFICATION OF RABBIT PLATELET SECRETORY PHOSPHOLIPASE-A2 AND ITS CHARACTERISTICS [J].
MIZUSHIMA, H ;
KUDO, I ;
HORIGOME, K ;
MURAKAMI, M ;
HAYAKAWA, M ;
KIM, DK ;
KONDO, E ;
TOMITA, M ;
INOUE, K .
JOURNAL OF BIOCHEMISTRY, 1989, 105 (04) :520-525
[18]  
MORA EM, 1991, ARCH SURG-CHICAGO, V126, P157
[19]   DETECTION OF 3 DISTINCT PHOSPHOLIPASES A2 IN CULTURED MAST-CELLS [J].
MURAKAMI, M ;
KUDO, I ;
UMEDA, M ;
MATSUZAWA, A ;
TAKEDA, M ;
KOMADA, M ;
FUJIMORI, Y ;
TAKAHASHI, K ;
INOUE, K .
JOURNAL OF BIOCHEMISTRY, 1992, 111 (02) :175-181
[20]   EXACERBATION OF RAT ADJUVANT ARTHRITIS BY INTRADERMAL INJECTION OF PURIFIED MAMMALIAN 14-KDA GROUP-II PHOSPHOLIPASE-A2 [J].
MURAKAMI, M ;
KUDO, I ;
NAKAMURA, H ;
YOKOYAMA, Y ;
MORI, H ;
INOUE, K .
FEBS LETTERS, 1990, 268 (01) :113-116