Combination of hemofiltration and peritoneal dialysis in the treatment of severe acute pancreatitis.

Objective: Our aim was to study the therapeutic effects and the mechanism of combination of hemofiltration (HF) and peritoneal dialysis (PD) in the treatment of severe acute pancreatitis (SAP).

Methods: Fifty-one cases of SAP were randomly divided into the HF+PD group (treated group, 36 patients) and the non-HF+PD group (control group, 15 patients). Both groups were treated by the same traditional methods. The relief time of abdominal pain and abdominal distension, computed tomographic scores, acute physiology and chronic health enquiry II scores, length of stay, cost of hospitalization, operability, and recovery rate of the 2 groups were compared. The concentration of tumor necrosis factor-alpha, IL-6, and IL-8 in serum and ascites volumes was determined before and after treatment.

Results: : The mean time of abdominal pain relief, amelioration of abdominal distension, decrease of computed tomographic scores, acute physiology and chronic health enquiry II scores, the mean length of stay, and cost of hospitalization of the treated group were significantly shorter or less than those of the control group. The aforementioned inflammatory cytokines, detected at the end of 1 day and 2 days after HF+PD treatment, were decreased significantly compared with those observed in pretherapy and the control group.

Conclusions: Inflammatory cytokines, which overproduced in SAP, can be eliminated effectively from the blood and the ascites by HF+PD treatment.