scholarly journals Tu1423 – Role of Inflammatory Markers in Step-Up Approach in Acute Necrotizing Pancreatitis: Results of a Prospective Study

2019 ◽  
Vol 156 (6) ◽  
pp. S-1033
Author(s):  
Aditya Kulkarni ◽  
Rajesh Gupta ◽  
Surinder S. Rana ◽  
Mandeep Kang ◽  
Harjeet Singh ◽  
...  
Author(s):  
George Sakellaris ◽  
Dimitra Dimopoulou ◽  
Maria Niniraki ◽  
Anastasia Dimopoulou ◽  
Athanasios Alegakis ◽  
...  

2021 ◽  
Vol 33 (5) ◽  
pp. 762-763
Author(s):  
Elmas Biberci Keskin ◽  
Gülay Okay ◽  
Duygu Muhiddin ◽  
Rasul Sharif ◽  
Bahadir Taşlidere ◽  
...  

2010 ◽  
Vol 29 (4) ◽  
pp. 329-337 ◽  
Author(s):  
Shi Cheng ◽  
Wen-Mao Yan ◽  
Bin Yang ◽  
Jing-dong Shi ◽  
Mao-min Song ◽  
...  

To investigate the role of nitric oxide (NO) in acute lung inflammation and injury secondary to acute necrotizing pancreatitis (ANP), 5% sodium taurocholate was retrogradely injected into the biliopancreatic duct of rats to ANP model. These ANP rats were given L-Arginine (L-Arg, 100 mg/kg), L-NAME (10 mg/kg), or their combination by intraperitoneal injection 30 min prior to ANP induction. At 1, 3, 6, and 12 hours after ANP induction, lung NO production, and inducible NO synthase (iNOS) expression were measured. Lung histopathological changes, bronchoalveolar lavage (BAL) protein concentration, proinflammatory mediators tumor necrotic factor alpha (TNF-α), and lung tissue myeloperoxidase (MPO) activity were examined. Results showed that NO production and iNOS mRNA expression in alveolar macrophages (AMs) were significantly increased along with significant increases in lung histological abnormalities and BAL proteins in the ANP group, all of which were further enhanced by pretreatment with L-Arg and attenuated by pretreatment with L-NAME, respectively. These markers were slightly attenuated by pretreatment with combination of L-Arg + L-NAME, suggesting that NO is required for initiating the acute lung damage in ANP rats, and also that L-Arg-enhanced lung injury is mediated by its NO generation rather than its direct effect. MPO activity and TNF-α expression in lung were upregulated in the ANP rats and further enhanced by pretreatment with L-Arg and attenuated by pretreatment with L-NAME, respectively. These results suggest that overproduction of NO mediated by iNOS in the lung is required for the acute lung inflammation and damage secondary to ANP.


ISRN Surgery ◽  
2013 ◽  
Vol 2013 ◽  
pp. 1-10 ◽  
Author(s):  
K. Vasiliadis ◽  
C. Papavasiliou ◽  
A. Al Nimer ◽  
N. Lamprou ◽  
C. Makridis

The optimal management of necrotizing pancreatitis continues to evolve. Currently, conservative intensive care treatment represents the primary therapy of acute severe necrotizing pancreatitis, aiming at prevention of organ failure. Following this mode of treatment most patients with sterile necroses can be managed successfully. Surgery might be considered as an option in the late phase of the disease for patients with proven infected pancreatic necroses and organ failure. For these patients surgical debridement is still considered the treatment of choice. However, even for this subgroup of patients, the concept of operative strategy has been recently challenged. Nowadays, it is generally accepted that necrotizing pancreatitis with proven infected necroses as well as septic complications directly caused by pancreatic infection are strong indications for surgical management. However, the question of the most appropriate surgical technique for the treatment of pancreatic necroses remains unsettled. At the same time, recent advances in radiological imaging, new developments in interventional radiology, and other minimal access interventions have revolutionised the management of necrotizing pancreatitis. In light of these controversies, the present paper will focus on the current role of surgery in terms of open necrosectomy in the management of severe acute necrotizing pancreatitis.


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