Continuous peritoneal dialysis in acute experimental pancreatitis in dogs. Effect of aprotinin in the dialysate medium

In 27 beagle dogs, acute necrotizing pancreatitis was induced by retrograde injection of autologous bile and trypsin into the main pancreatic duct. Animals were randomly assigned to the following treatments: group 1--(9 dogs) aprotinin 600,000 KIU/d by i.v. route; group 2--(9 dogs) peritoneal dialysis for 6 d plus 500,000 KIU/L of aprotinin in the dialysate fluid; group 3--(9 dogs) peritoneal dialysis without aprotinin in the dialysate fluid. All dogs of the group 1 died within 16 h following the induction of pancreatitis and extensive necrotizing and hemorrhagic changes were seen in the pancreatic and peripancreatic areas. Six dogs of the group 2 survived and no necrotizing changes were observed 30 or 50 d after the induction of pancreatitis. Three dogs of the group 3 survived, but slight necrotizing lesions were found at the autopsy. The survival rate was higher in dogs with peritoneal lavage (p = 0.0129) or with peritoneal lavage plus aprotinin (p less than 0.0001) than in those receiving i.v. aprotinin, indicating that the latter treatment has no beneficiary effect on the course of acute pancreatitis.