The role of ultrasound-guided peritoneal lavage and drainage in the treatment of severe acute pancreatitis

Objective To explore the therapeutic effect of continuous peritoneal lavage and drainage guided by ultrasound in the treatment of severe acute pancreatitis (SAP). Method A total of 45 patients with SAP were divided into 2 groups: treatment group (20 cases) and control group (25 cases). There were no significant difference in the mean age, comorbidity rate, the symptoms, body temperature, heart rate, WBC count, and serum and urine amylase levels on the admission day between the 2 groups (P0.05). Twenty patients in treatment group, include 13 with biliary calculus, were treated with continuous peritoneal lavage and drainage guided by ultrasound in combination with conservative therapy. In control group, 21 patients were treated with similar conservative therapy, and the other 4 underwent surgery. The amount of peritoneal lavage, body temperature, heart rate, WBC count, serum and urine amylase levels were examined every day. These parameters recorded on the 5th day after treatment were compared with those before treatment. And the changes of the parameters pre- and post-treatment were compared between the 2 groups. Results On the 5th d after treatment, the body temperature, heart rate, WBC count, serum and urine amylase levels were obviously decreased in treatment group; and the decreases in these parameters were much more significant compared with control group (P0.01). The mean hospital stay of treatment and control groups was (26.8±13.2) d and (29.6±13.5) d, respectively (P0.05). Conclusions Peritoneal lavage and drainage guided by ultrasound is safe, convenient, less traumatic and highly effective in the treatment of SAP, and the patients can make a rapid recovery, therefore it is of clinical significance.