Abstract
Background and purpose; “Evidence-based medical care guidelines for acute pancreatitis” was published in 2003, outlining a treatment strategy for severe acute pancreatitis. Based on these guidelines, we performed intensive care, mainly intra-arterial infusion therapy, for the treatment of severe acute pancreatitis and obtained good results. Using CT images, we examined the improvements in pancreatic perfusion and the outcome of intra-arterial infusion therapy using nafamostat mesilate and imipenem (FUT+IPM). Cases and Methods; Seventy-two cases with a lowdensity area (LDA) >30% on their CT image taken at the time of admission and treated with intra-arterial infusion therapy were included in the study. The morphologic changes (improvement rate) in the pancreatic LDA were then examined after intra-arterial infusion therapy. Results ; The improvement rate of patients with a baseline LDA of 30-50% was 71%, while that of patients with a baseline LDA of>50% was 64%. Regarding the LDA spread, the improvement rate tended to decrease. Discussion and Conclusion ; Early intra-arterial infusion therapy may improve pancreatic perfusion and decrease the incidence of complications, such as infectious pancreatic necrosis, thereby improving patient outcome.
