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Application of Herbal Medicine and Oxygen Infusions into the Duodenal Lumen in Severe Acute Pancreatitis

Gun-Son Ri, Tong-Chil Hyon, Young-Bok Pak, Gwang-Rok Ho, Myong-Chol Zhon


Background: Severe acute pancreatitis is associated with a high rate of complications and significant mortality. Although surgical intervention has been widely introduced instead of open surgery in treating severe acute pancreatitis, there have been still complications and mortality associated with severe acute pancreatitis. Object: Our study aimed at reducing complications and mortality associated with severe acute pancreatitis. Methods: Herbal medicine (Korean rhubarb) and oxygen infusions into the duodenal lumen combined with percutaneous drains into the abdominal cavity were introduced in the treatment of severe acute pancreatitis. Comparison was made between surgical intervention or conventional open techniques (control) and our new treatment (study). Conclusion: The herbal medicine and oxygen infusion into the duodenal lumen with a tube placed into the recto-vesical fossa in the treatment of severe acute pancreatitis showed less invasion, reduced average recovery days of main symptoms and signs with less complications and mortality, and had shorter days for treatment compared with surgical intervention or conventional open techniques


Acute pancreatitis, infected necrosis, Korean rhubarb, necrotizing pancreatitis, surgical intervention, sphincter of Oddi dysfunction

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Isenmann R, Ran B, Berger HG. Early Severe Acute Pancreatitis: Characteristics of a New Subgroup. Pancreas. 2001; 22(3): 274 278p.

Connor S, Alexakis, N, Raraty, MG, et al. Early and Late Complications after Pancreatic Necrosectomy. Surgery. 2005; 137(5): 499 505p.

Banks PA, Freeman ML. Practice Parameters Committee of the American College of Gastroenterology. Practice Guidelines in Acute Pancreatitis. Am J Gastroenterol. 2006; 101(10): 2379 2400p.

Johnson C, Charnley R, Rowlands B, et al. UK Guidelines for the Management of Acute Pancreatitis. Gut. 2005; 54(Suppl 3): 1 9p.

Forsmark CE, Baillie J. AGA Institute Clinical Practice and Economics Committee, AGA Institute Governing Board. AGA Institute Technical Review on Acute Pancreatitis. Gastroenterology. 2007; 132(5): 2022 2044p.

Beger HG, Bittner R, Block S, Büchler M. Bacterial Contamination of Pancreatic Necrosis. A Prospective Clinical Study. Gastroenterology. 1986; 91(2): 433 438p.

Besselink MG, Verwer TJ, Schoenmaeckers EJ, et al. Timing of Surgical Intervention in Necrotizing Pancreatitis. Arch Surg. 2007; 142(12): 1194 1201p.

Bradley EL 3rd, Allen K. A Prospective Longitudinal Study of Observation versus Surgical Intervention in the Management of Necrotizing Pancreatitis. Am J Surg. 1991; 161(1): 19 24p.

Ai X, Qian X, Pan W, et al. Ultrasound Guided Percutaneous Drainage may Decrease the Mortality of Severe Acute Pancreatitis. J Gastroenterol. 2010; 45(1): 77 85p.

Marik PE, Zaloga GP. Early Enteral Nutrition in Acutely Ill Patients: A Systematic Review. Crit Care Med. 2001; 29(12): 2264 2270p.

van Santvoort HC, Besselink MG, Bakker OJ, et al. A Step Up Approach or Open Necrosectomy for Necrotizing Pancreatitis. N Engl J Med. 2010; 362(16): 1491 1502p.

Kaw M, Brodmerkel GJ Jr. ERCP, Biliary Crystal Analysis, and Sphincter of Oddi Manometry in Idiopathic Recurrent Pancreatitis. Gastrointest Endosc. 2002; 55(2): 157 162p.

Coyle WJ, Pineau BC, Tarnasky PR, et al. Evaluation of Unexplained Acute and Acute Recurrent Pancreatitis Using Endoscopic Retrograde Cholangiopancreatography, Sphincter of Oddi Manometry and Endoscopic Ultrasound. Endoscopy. 2002; 34(8): 617 623p.

De Waele JJ, De Laet I, Kirkpatrick AW, Hoste E. Intra abdominal Hypertension and Abdominal Compartment Syndrome. Am J Kidney Dis. 2011; 57(1): 159 169p.

Marik PE, Zaloga GP. Meta Analysis of Parenteral Nutrition versus Enteral Nutrition in Patients with Acute Pancreatitis. BMJ. 2004; 328(7453): 1407p.

McClave SA, Chang WK, Dhaliwal R, Heyland DK. Nutrition Support in Acute Pancreatitis: A Systematic Review of the Literature. J Parenter Enteral Nutr (JPEN). 2006; 30(2): 143 156p.

Krishnan K. Nutritional Management of Acute Pancreatitis. Curr Opin Gastroenterol. Mar 2017; 33(2): 102 6p.

Goldman P. Herbal Medicines Today and the Roots of Modern Pharmacology. Ann Intern Med. 2001; 135(8 Pt 1): 594 600p.

Radenkovic DV, Bajec D, Ivancevic N, et al. Decompressive Laparotomy with Temporary Abdominal Closure Versus Percutaneous Puncture with Placement of Abdominal Catheter in Patients with Abdominal Compartment Syndrome during Acute Pancreatitis: Background and Design of Multicenter, Randomised, Controlled Study. BMC Surg. 2010; 10: 22p.

Cheatham ML, Malbrain ML, Kirkpatrick A, et al. Results from the International Conference of Experts on Intra abdominal Hypertension and Abdominal Compartment Syndrome. II. Recommendations. Intensive Care Med. 2007; 33(6): 951 962p.

Eatock FC, Chong P, Menezes N, et al. A Randomized Study of Early Nasogastric versus Nasojejunal Feeding in Severe Acute Pancreatitis. Am J Gastroenterol. 2005; 100(2): 432 439p.


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