The Effectiveness of Local Hypothermia and Peritoneal Lavage-Dialysis in the Treatment of Patients with Acute Destructive Pancreatitis

Veniamin I. Shaposhnikov, PhD, ScD*, Svetlana N. Ralko

Kuban State Medical University, Krasnodar, Russian Federation

*Corresponding author: Professor Veniamin I. Shaposhnikov, Hospital Surgery Department, Kuban State Medical University, 4 Sedin str., 350063, Krasnodar, Russian Federation. Tel: 8- 918- 3446404 (mobile).


The aim of this study was to improve the principles of the pathogenetic therapy of acute pancreatitis and assess the effectiveness of local hypothermia of the pancreas, as well as peritoneal lavage-dialysis in the treatment of acute destructive pancreatitis. A total of 5889 patients with acute pancreatitis (AP) were examined. The leading role played by the lesions of the pancreatic lymphatic system in the development of destructive processes was noted. In experiments done on eight dogs, the first day of experimental acute pancreatitis showed necrosis of the lumbar retroperitoneal lymph nodes with a violation of lymph drainage from the pancreas before the retroperitoneal fat necrosis was initiated. The effectiveness of local hypothermia of the pancreas was experimentally demonstrated. In 32 patients with AP, the perioperative local hypothermia of the pancreas for 20-25 minutes was followed by the reduction of the alpha-amylase activity in the peripheral blood and in the portal system, as well as a significant reduction in the edema of the pancreas, that delayed the progression of the destructive lesions. An effective method of performing lavage-dialysis of the omental bursa, by using a transversely perforated tube with a pollution control device in the lumen, was developed.

pancreas; lymphatic system; acute pancreatitis.
  1. Alperovich VM, Meralikin NP, Portnyagin MP. Cryosurgery of pancreas in acute destructive pancreatitis. Surgery 1993; 11:64-70. [in Russian].
  2. Brekhov EI, Reshetnikov EA, Mironov AC, et al. Diagnosis and treatment of sterile pancreonecrosis.  Surgery 2006; 9: 31-35. [in Russian].
  3.  Savelyev VS.  Pancreatonecrosis. M.: MIA, 2008.  [in Russian].
  4. Savelyev VS, Filimonov MI, Gelfand BR, et al.  Destructive pancreatitis: diagnostic and treatment. Consilium medicum 2001; 6: 273-279. [in Russian].
  5. Zatevakhin II.  Evaluation of organ and extraorgan lesions in acute destructive pancreatitis and its effect on mortality. Annals of Surgery 2002; 1: 35-42.  [in Russian].
  6. Lutsevich EV, Chepelenko G.V. Pancreas as one a targets of “the auto enzymatic explosion" in pancreatitis. Surgery 2001; 9:57-60. [in Russian].
  7. Kozlov VA, Starodubov VI, Nikiforov AI.  Local hypothermia of the pancreas in the surgical treatment of pancreatitis. 30th  All-Union Congress of Surgeons. Minsk, 1981; P.218-219. [in Russian].
  8. Shalimov AA, Shalimov SA, Zemskov VS, et al.  Hypothermia in surgery of the pancreas. Clinical Surgery 1982; 11:1-7. [in Russian].
  9. Yarema IV, Kazarian VM, Kaadze MK, Naletov VV, Koshelev IA. The role of lymphatic methods of immunocorrection in treatment of acute pancreatitis.  4th   Congress of Russian Lymphologists. Moscow 2011; p.182-185. [in Russian].
  10. Shalimov AA, Shaposhnikov VI, Pinchuk MP. Acute peritonitis. Kiev: "Naukova Dumka", 1981. [in Russian].
  11. Savelyev VS, Buyanov VM, Ognev VYu. Acute pancreatitis. M.: Medicine, 1983. [in Russian].

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Int J Biomed. 2012; 2(4):271-274. © 2012 International Medical Research and Development Corporation. All rights reserved.