Pancreas. 2025 Feb 12. doi: 10.1097/MPA.0000000000002478. Online ahead of print.
ABSTRACT
OBJECTIVE: To investigate the clinical efficacy of laparoscopic peritoneal lavage and drainage (LPLD) in the early stage of severe acute pancreatitis (SAP) and its potential role in reversing organ failure.
METHOD: This study involved 79 patients diagnosed with severe acute pancreatitis with ascites, who were admitted to the Affiliated Hospital of Youjiang Medical University of Nationalities between January 2020 and May 2024. Based on the intervention strategy, the patients were categorized into two groups: the abdominal paracentesis drainage (APD) group (n=42) and the LPLD group (n=37). We conducted a retrospective analysis comparing various parameters including demographic information, trends in inflammatory marker fluctuations, incidence of organ failure, step-up treatment, duration of ICU stay, drainage tube indwelling time, complications, total hospitalization days, total hospitalization cost , and mortality rates.
RESULTS: In addition to the observation that the preoperative volume of ascites was significantly greater in the APD group compared to the LPLD group (P = 0.005), the baseline characteristics of both groups were comparable. Postoperatively, The white blood cell count and C-reactive protein levels in the LPLD group exhibited a significantly faster decline compared to those in the APD group. (P < 0.05 and P < 0.001). There were no statistically significant differences in the rates of hemodialysis, pancreatic pseudocyst, abdominal compartment syndrome (ACS)，and mortality between the two patient groups. (P > 0.05). The LPLD group exhibited significantly reduced durations for mechanical ventilation, step-up treatment, duration of ICU stay, drainage tube indwelling time, duration of systemic inflammatory response syndrome (SIRS), incidence of intra-abdominal infection, new onset organ dysfunctions, total hospitalization days, and total hospitalization cost when compared to the APD group (P < 0.05).
CONCLUSIONS: In patients with SAP complicated by ascites, early-stage LPLD can effectively alleviate systemic inflammatory response, expedite organ failure reversal, delay disease progression, avoid step-up treatment, reduce postoperative complications and shorten hospitalization duration. This minimally invasive therapeutic approach represents a promising strategy for early intervention in SAP.
PMID:39933051 | DOI:10.1097/MPA.0000000000002478
