Continuous regional arterial infusion therapy with gabexate mesilate for severe acute pancreatitis

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 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 nonCRAI 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. (C) 2008 The WJG Press. All rights reserved.