Continuous arterial infusion of protease inhibitor with supplementary therapy for the patients with severe acute pancreatitis - Clinical effect of arterial injection of ulinastatin

Hidehiko Matsukawa, Ayumi Hara, Takashi Ito, Kazuto Fukui, Koichi Sato, Masashi Ichikawa, Masahiro Yoshioka, Hiroaki Seki, Kenichi Yamataka, Ken Takizawa, Shigeo Okuda, Nobuyuki Shiraga

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Abstract

We treated five patients with severe acute pancreatitis by continuous arterial infusion (CAI) of protease inhibitor, nafamostat mesilate. Arterial injection (AI) of ulinastatin was performed in four cases and AI of antibiotics (IPM/CS) was done in one case, as supplemental therapies of CAI. Abdominal pain disappeared in 7.9 hours on the average, abdominal tenderness disappeared in 5.0 days and laboratory data lately recovered. All five cases treated by these therapies were cured without hemodialysis or surgical treatment in acute phase. AI of ulinastatin through arterial infusion catheter is pharmacokinetically more effective, because it yields a relatively high concentration of the drug at the acting site when compared with that of intravenous injection. Furthermore, ulinastatin inhibits different types of protease from nafamostat mesilate. Therefore the clinical effect of CAI of nafamostat mesilate is enhanced by the combined therapy with AI of ulinastatin. It is also suggested that arterial injection of ulinastatin might be effective for the control of abdominal pain and that arterial injection of antibiotics might have an advantage on prevention of infectious pancreatic necrosis.

Original languageEnglish
Pages (from-to)1229-1234
Number of pages6
JournalJapanese Journal of Gastroenterology
Volume95
Issue number11
Publication statusPublished - 1998 Nov 1
Externally publishedYes

ASJC Scopus subject areas

  • Gastroenterology

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    Matsukawa, H., Hara, A., Ito, T., Fukui, K., Sato, K., Ichikawa, M., Yoshioka, M., Seki, H., Yamataka, K., Takizawa, K., Okuda, S., & Shiraga, N. (1998). Continuous arterial infusion of protease inhibitor with supplementary therapy for the patients with severe acute pancreatitis - Clinical effect of arterial injection of ulinastatin. Japanese Journal of Gastroenterology, 95(11), 1229-1234.