Low Molecular Weight Heparin in the Treatment of Severe Acute Pancreatitis: A Multiple Centre Prospective Clinical Study

BACKGROUND Acute pancreatitis (AP) runs a moderately severe and severe course in around 20 % - 30 % of cases. It can progress into severe acute pancreatitis (SAP) and pancreatic necrosis if not appropriately intervened. This study aims to study the effect of low molecular weight heparin in treating acute pancreatitis. METHODS This was a prospective hospital-based study. Patients presenting to the emergency ward in our hospital with acute pancreatitis features with a duration of 72 hours or less and fulfilling the inclusion and exclusion criteria were included. They were randomly divided into those receiving standard care alone, and standard care low molecular weight heparin in addition to routine management, and results were calculated using the chi-square test. RESULTS The number of patients in the present study was 100. The most common age group affected was 30 - 40 years. Out of 100, 94 were male patients, and 6 were female patients. There is no notable difference in the mean age group between the groups. The recovery percentage is 98 % in patients with low molecular weight heparin. The recovery rate is 86 % in patients without low molecular weight heparin. The mortality rate is 2 % in patients with low molecular weight heparin. The mortality rate is 14 % in patients without low molecular weight heparin. It was found that the low molecular weight heparin usage has brought a significant difference in the patients. Outcome affected with acute pancreatitis had a significant P - value of 0.02. CONCLUSIONS The low molecular weight heparin by its property of improving the micro circulations relieves the abdominal pain, prevents the disease's further progression, and hence reduces the duration of hospital stay, morbidity, and mortality associated with the disease and enhances the recovery rate. KEYWORDS Acute Pancreatitis, Severe Acute Pancreatitis, Low Molecular Weight Heparin, Microcirculation, Systemic Inflammatory Response

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Prophylactic low-molecular-weight heparin administration protected against severe acute pancreatitis partially by VEGF/Flt-1 signaling in a rat model

Human & Experimental Toxicology ◽

10.1177/0960327120919469 ◽

2020 ◽

Vol 39 (10) ◽

pp. 1345-1354

Author(s):

S Li ◽

S Zhang ◽

R Li ◽

S Chen ◽

S Chang ◽

...

Keyword(s):

Molecular Weight ◽

Acute Pancreatitis ◽

Western Blot ◽

Severe Acute Pancreatitis ◽

Rat Model ◽

Low Molecular Weight Heparin ◽

Sodium Taurocholate ◽

Underlying Mechanism ◽

Low Molecular Weight ◽

Oxidative Response

Background: The present study was aimed to explore the effects and the underlying mechanism of prophylactic low-molecular-weight heparin (LMWH) treatment on taurocholate-induced severe acute pancreatitis (SAP) in a rat model. Methods: Rat SAP model was induced by injection of 4% sodium taurocholate into the pancreatic duct. LMWH was applied half an hour before the induction of pancreatitis at the dose of 200 IU/kg subcutaneous injection. The rats were euthanized at 1 h, 6 h, and 12 h after taurocholate-induced SAP. The inflammatory and oxidative response markers were assessed. And the vascular endothelial growth factor (VEGF) and Fms-related tyrosine kinase 1 (Flt-1) expression were evaluated by immunohistochemistry (IHC) and western blot methods. Results: The expression of inflammatory and oxidative response markers increased after induction of SAP. IHC and western blot results showed the VEGF and Flt-1 expression were increased in SAP group. Prophylactic LMWH administration reduced the inflammatory and oxidative response markers expression and decreased the expression of VEGF and Flt-1. Conclusions: This study suggested that prophylactic LMWH treatment mitigated the severity of pancreatitis in rat SAP model by anti-inflammation and oxidative response. The underlying mechanism may result from downregulating VEGF/Flt-1 signaling of LMWH in SAP rat model.

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