Research advances in acute pancreatitis-associated ascites fluid

Zhangpeng WANG; Jun WU; Guangxu JING; Xuyang WANG; Hong ZOU; Hongyu SUN; Lijun TANG

doi:10.3969/j.issn.1001-5256.2023.05.035

Volume 39 Issue 5

May 2023

Turn off MathJax

Article Contents

Article Navigation > Journal of Clinical Hepatology > 2023 > 39(5): 1227-1233

PDF( 1890 KB)

Research advances in acute pancreatitis-associated ascites fluid

DOI: 10.3969/j.issn.1001-5256.2023.05.035

Zhangpeng WANG^{1a, 2},
Jun WU^{1a, 3},
Guangxu JING^{1a, 2},
Xuyang WANG^{1a, 4},
Hong ZOU^1a,
Hongyu SUN^{1a, 1b},
Lijun TANG^{1a, 2
,
,
,}

1a.
PLA Center of General Surgery/Key Laboratory of Pancreatic Injury and Repair of Sichuan Province, The General Hospital of Western Theater Command, Chengdu 610083, China
1b.
Basic Medical Laboratory, The General Hospital of Western Theater Command, Chengdu 610083, China
2.
College of Medicine, Southwest Medical University, Luzhou, Sichuan 646000, China
3.
College of Medicine, Southwest Jiaotong University, Chengdu 610063, China
4.
College of Medicine, Chongqing Medical University, Chongqing 400016, China

Research funding:

National Clinical Key Subject of China (41732113)

More Information

Corresponding author: TANG Lijun, tanglj2016@163.com (ORCID: 0000-0001-6000-9515)
Received Date: 2022-08-23
Accepted Date: 2022-09-23
Published Date: 2023-05-20

Abstract

Abstract

Acute pancreatitis-associated ascites fluid (PAAF) is a common complication in patients with acute pancreatitis (AP) and is closely associated with the severity of AP, the development of local and systemic complications, and prognosis. PAAF may originate from the leakage of abdominal blood vessels, lymphatic vessels, and pancreatic duct. Recent studies have found that early removal of PAAF by abdominal paracentesis drainage can help to reduce systemic inflammation and alleviate pancreatitis-associated organ injury, thereby improving the conditions of patients with severe AP and reducing mortality. However, it is still not completely clear how PAAF aggravates systemic inflammatory response, participates in pancreatic injury and damage of distal organs, and leads to the aggravation of disease conditions in patients with AP. Therefore, this article gives an overview of PAAF and summarizes related studies in recent years, so as to provide directions for exploring the pathophysiological process and treatment of AP.
- Pancreatitis,
- Ascites Fluid,
- Pathologic Processes

FullText(HTML)

References(50)

References

[1]	MEDEROS MA, REBER HA, GIRGIS MD. Acute pancreatitis: a review[J]. JAMA, 2021, 325(4): 382-390. DOI: 10.1001/jama.2020.20317.
[2]	Chinese Pancreatic Surgery Association. Guidelines for diagnosis and treatment of acute pancreatitis in China (2021)[J]. Chin J Surg, 2021, 59(7) : 578-587. DOI: 10.3760/cma.j.cn112139-20210416-00172. 中华医学会外科学分会胰腺外科学组. 中国急性胰腺炎诊治指南(2021)[J]. 中华外科杂志, 2021, 59(7) : 578-587. DOI: 10.3760/cma.j.cn112139-20210416-00172.
[3]	SHARMA D, JAKKAMPUDI A, REDDY R, et al. Association of systemic inflammatory and anti-inflammatory responses with adverse outcomes in acute pancreatitis: preliminary results of an ongoing study[J]. Dig Dis Sci, 2017, 62(12): 3468-3478. DOI: 10.1007/s10620-017-4813-6.
[4]	BUSH N, RANA SS. Ascites in acute pancreatitis: clinical implications and management[J]. Dig Dis Sci, 2022, 67(6): 1987-1993. DOI: 10.1007/s10620-021-07063-6.
[5]	SAMANTA J, RANA A, DHAKA N, et al. Ascites in acute pancreatitis: not a silent bystander[J]. Pancreatology, 2019, 19(5): 646-652. DOI: 10.1016/j.pan.2019.06.004.
[6]	LIU WH, REN LN, CHEN T, et al. Abdominal paracentesis drainage ahead of percutaneous catheter drainage benefits patients attacked by acute pancreatitis with fluid collections: a retrospective clinical cohort study[J]. Crit Care Med, 2015, 43(1): 109-119. DOI: 10.1097/CCM.0000000000000606.
[7]	ZENG QX, WU ZH, HUANG DL, et al. Association between ascites and clinical findings in patients with acute pancreatitis: a retrospective study[J]. Med Sci Monit, 2021, 27: e933196. DOI: 10.12659/MSM.933196.
[8]	JARDINET T, VERBEKE L, BONNE L, et al. Therapeutic intranodal lymphangiography for refractory chylous ascites complicating acute necrotic pancreatitis[J]. J Gastrointestin Liver Dis, 2018, 27(2): 195-197. DOI: 10.15403/jgld.2014.1121.272.the.
[9]	BOXHOORN L, VOERMANS RP, BOUWENSE SA, et al. Acute pancreatitis[J]. Lancet, 2020, 396(10252): 726-734. DOI: 10.1016/S0140-6736(20)31310-6.
[10]	Chinese Society for Emergency Medicine, Beijing-Tianjin-Hebei Alliance of Emergency Treatment and First Aid, Emergency Medicine Branch, Beijing Medical Association, et al. Expert consensus on emergency diagnosis and treatment of acute pancreatitis[J]. J Clin Hepatol, 2021, 37(5): 1034-1041. DOI: 10.3969/j.issn.1001-5256.2021.05.012. 中华医学会急诊分会, 京津冀急诊急救联盟, 北京医学会急诊分会, 等. 急性胰腺炎急诊诊断及治疗专家共识[J]. 临床肝胆病杂志, 2021, 37(5): 1034-1041. DOI: 10.3969/j.issn.1001-5256.2021.05.012.
[11]	YANG X, LIU RH, XIE C, et al. Protective effect of early abdominal paracentesis drainage against kidney injury secondary to severe acute pancreatitis[J]. Chin J Gen Surg, 2021, 30(3): 321-329. DOI: 10.7659/j.issn.1005-6947.2021.03.010. 杨熊, 刘若鸿, 谢川, 等. 早期腹腔穿刺引流对重症急性胰腺炎肾损伤的保护作用[J]. 中国普通外科杂志, 2021, 30(3): 321-329. DOI: 10.7659/j.issn.1005-6947.2021.03.010.
[12]	JIANG M, JIN J, ZHENG J, et al. Efficacy of early minimally invasive catheterization continuous abdominal lavage and drainage in treatment of acute pancreatitis[J]. Chin J Endocr Surg, 2021, 15(2): 193-196. DOI: 10.3760/cma.j.cn.115807-20200701-00204. 姜明, 金晶, 郑杰, 等. 早期微创置管持续腹腔灌洗引流治疗急性胰腺炎的疗效观察[J]. 中华内分泌外科杂志, 2021, 15(2): 193-196. DOI: 10.3760/cma.j.cn.115807-20200701-00204.
[13]	LU Z, ZHU X, HUA T, et al. Efficacy and safety of abdominal paracentesis drainage on patients with acute pancreatitis: a systematic review and meta-analysis[J]. BMJ Open, 2021, 11(8): e045031. DOI: 10.1136/bmjopen-2020-045031.
[14]	ZEREM E, KUNOSI S, ZEREM D, et al. Benefits of abdominal paracentesis drainage performed ahead of percutaneous catheter drainage as a mo dification of the step-up approach in acute pancreatitis with fluid collections[J]. Acta Gastroenterol Belg, 2020, 83(2): 285-293.
[15]	LI Z, XIA C, ZHANG L, et al. Peritoneal lavage for severe acute pancreatitis: a meta-analysis and systematic review[J]. Pancreas, 2016, 45(6): 806-813. DOI: 10.1097/MPA.0000000000000530.
[16]	DONG Z, PETROV MS, XU J, et al. Peritoneal lavage for severe acute pancreatitis: a systematic review of randomised trials[J]. World J Surg, 2010, 34(9): 2103-2108. DOI: 10.1007/s00268-010-0665-3.
[17]	HONGYIN L, ZHU H, TAO W, et al. Abdominal paracentesis drainage improves tolerance of enteral nutrition in acute pancreatitis: a randomized controlled trial[J]. Scand J Gastroenterol, 2017, 52(4): 389-395. DOI: 10.1080/00365521.2016.1276617.
[18]	ZHOU J, HUANG Z, CHENG L, et al. Abdominal paracentesis drainage (APD) attenuates acute pancreatitis-associated lung injury in patients with ascitic fluids: a retrospective study[J]. Int J Clin Exp Med, 2016, 9(9): 18400-18409.
[19]	LIU L, YAN H, LIU W, et al. Abdominal paracentesis drainage does not increase infection in severe acute pancreatitis: a prospective study[J]. J Clin Gastroenterol, 2015, 49(9): 757-763. DOI: 10.1097/MCG.0000000000000358.
[20]	SU JL, HUANG Z, SUN HY, et al. Impact of timing of abdominal paracentesis drainage on treatment outcomes in patients with severe acute pancreatitis[J]. Chin J Hepatobiliary Surg, 2018, 24 (10): 692-697. DOI: 10.3760/cma.j.issn.1007-8118.2018.10.009. 苏江林, 黄竹, 孙红玉, 等. 腹腔引流穿刺时机对重症急性胰腺炎患者预后的影响[J]. 中华肝胆外科杂志, 2018, 24 (10): 692-697. DOI: 10.3760/cma.j.issn.1007-8118.2018.10.009.
[21]	LIU RH, WEN Y, SUN HY, et al. Abdominal paracentesis drainage ameliorates severe acute pancreatitis in rats by regulating the polarization of peritoneal macrophages[J]. World J Gastroenterol, 2018, 24(45): 5131-5143. DOI: 10.3748/wjg.v24.i45.5131.
[22]	LI YY, LU XY, LI XJ, et al. Intervention of pyrrolidine dithiocarbamate and tetrandrine on cellular calcium overload of pancreatic acinar cells induced by serum and ascitic fluid from rats with acute pancreatitis[J]. J Gastroenterol Hepatol, 2009, 24(1): 155-165. DOI: 10.1111/j.1440-1746.2008.05592.x.
[23]	GUTIERREZ PT, FOLCH-PUY E, BULBENA O, et al. Oxidised lipids present in ascitic fluid interfere with the regulation of the macrophages during acute pancreatitis, promoting an exacerbation of the inflammatory response[J]. Gut, 2008, 57(5): 642-648. DOI: 10.1136/gut.2007.127472.
[24]	WU J, LU YC, HUANG Z, et al. Effect of abdominal paracentesis drainage on pancreatic pyroptosis of rats with severe acute pancreatitis and its significance[J]. Med J Chin PLA, 2022, 47(9): 863-870. DOI: 10.11855/j.issn.0577-7402.2022.09.0863. 吴俊, 卢一琛, 黄竹, 等. 腹腔穿刺引流对重症急性胰腺炎大鼠胰腺细胞焦亡的影响及其意义[J]. 解放军医学杂志, 2022, 47(9): 863-870. DOI: 10.11855/j.issn.0577-7402.2022.09.0863.
[25]	LUO C, HUANG Q, YUAN X, et al. Abdominal paracentesis drainage attenuates severe acute pancreatitis by enhancing cell apoptosis via PI3K/AKT signaling pathway[J]. Apoptosis, 2020, 25(3-4): 290-303. DOI: 10.1007/s10495-020-01597-2.
[26]	FOGLIO EJ, GORELICK F. Abdominal paracentesis drainage: which patients with severe acute pancreatitis will benefit?[J]. J Clin Gastroenterol, 2015, 49(9): 717-719. DOI: 10.1097/MCG.0000000000000387.
[27]	GUKOVSKAYA AS, GUKOVSKY I, ALGVL H, et al. Autophagy, inflammation, and immune dysfunction in the pathogenesis of pancreatitis[J]. Gastroenterology, 2017, 153(5): 1212-1226. DOI: 10.1053/j.gastro.2017.08.071.
[28]	ZHOU J, HUANG Z, LIN N, et al. Abdominal paracentesis drainage protects rats against severe acute pancreatitis-associated lung injury by reducing the mobilization of intestinal XDH/XOD[J]. Free Radic Biol Med, 2016, 99: 374-384. DOI: 10.1016/j.freeradbiomed.2016.08.029.
[29]	PÉREZ S, PEREDA J, SABATER L, et al. Pancreatic ascites hemoglobin contributes to the systemic response in acute pancreatitis[J]. Free Radic Biol Med, 2015, 81: 145-155. DOI: 10.1016/j.freeradbiomed.2014.08.008.
[30]	PÉREZ S, PEREDA J, SABATER L, et al. Redox signaling in acute pancreatitis[J]. Redox Biol, 2015, 5: 1-14. DOI: 10.1016/j.redox.2015.01.014.
[31]	WANG X, ZHAO X, SHI C, et al. Potential mechanisms and significance of acute pancreatitis-associated liver injury[J]. Scand J Gastroenterol, 2006, 41(5): 604-613. DOI: 10.1080/00365520500347105.
[32]	XING ZX, SHEN SQ. Research progress in liver injury induced by severe acute pancreatitis[J]. J Abdominal Surg, 2016, 29(6): 478-481, 485. DOI: 10.3969/j.issn.1003-5591.2016.06.020. 邢志祥, 沈世强. 重症急性胰腺炎肝损伤的研究进展[J]. 腹部外科, 2016, 29(6): 478-481, 485. DOI: 10.3969/j.issn.1003-5591.2016.06.020.
[33]	YANG J, FIER A, CARTER Y, et al. Liver injury during acute pancreatitis: the role of pancreatitis-associated ascitic fluid (PAAF), p38-MAPK, and caspase-3 in inducing hepatocyte apoptosis[J]. J Gastrointest Surg, 2003, 7(2): 200-207; discussion 208. DOI: 10.1016/s1091-255x(02)00134-8.
[34]	HUANG SQ, WEN Y, SUN HY, et al. Abdominal paracentesis drainage attenuates intestinal inflammation in rats with severe acute pancreatitis by inhibiting the HMGB1-mediated TLR4 signaling pathway[J]. World J Gastroenterol, 2021, 27(9): 815-834. DOI: 10.3748/wjg.v27.i9.815.
[35]	CEN ME, WANG F, SU Y, et al. Gastrointestinal microecology: a crucial and potential target in acute pancreatitis[J]. Apoptosis, 2018, 23(7-8): 377-387. DOI: 10.1007/s10495-018-1464-9.
[36]	WEN Y, SUN HY, TAN Z, et al. Abdominal paracentesis drainage ameliorates myocardial injury in severe experimental pancreatitis rats through suppressing oxidative stress[J]. World J Gastroenterol, 2020, 26(1): 35-54. DOI: 10.3748/wjg.v26.i1.35.
[37]	HUANG L, ZHANG D, HAN W, et al. High-mobility group box-1 inhibition stabilizes intestinal permeability through tight junctions in experimental acute necrotizing pancreatitis[J]. Inflamm Res, 2019, 68(8): 677-689. DOI: 10.1007/s00011-019-01251-x.
[38]	WEN Y, LIU R, LIN N, et al. NADPH oxidase hyperactivity contributes to cardiac dysfunction and apoptosis in rats with severe experimental pancreatitis through ROS-mediated MAPK signaling pathway[J]. Oxid Med Cell Longev, 2019, 2019: 4578175. DOI: 10.1155/2019/4578175.
[39]	TAKASE K, TAKEYAMA Y, NISHIKAWA J, et al. Apoptotic cell death of renal tubules in experimental severe acute pancreatitis[J]. Surgery, 1999, 125(4): 411-420.
[40]	WANG T, LIU LY, LUO H, et al. Intra-abdominal pressure reduction after percutaneous catheter drainage is a protective factor for severe pancreatitis patients with sterile fluid collections[J]. Pancreas, 2016, 45(1): 127-133. DOI: 10.1097/MPA.0000000000000420.
[41]	PAPAVRAMIDIS TS, MICHALOPOULOS NA, MISTRIOTIS G, et al. Abdominal compliance, linearity between abdominal pressure and ascitic fluid volume[J]. J Emerg Trauma Shock, 2011, 4(2): 194-197. DOI: 10.4103/0974-2700.82205.
[42]	KIMBALL EJ. Intra-abdominal hypertension and abdominal compartment syndrome: a current review[J]. Curr Opin Crit Care, 2021, 27(2): 164-168. DOI: 10.1097/MCC.0000000000000797.
[43]	HE W, CHEN P, LEI Y, et al. Randomized controlled trial: neostigmine for intra-abdominal hypertension in acute pancreatitis[J]. Crit Care, 2022, 26(1): 52. DOI: 10.1186/s13054-022-03922-4.
[44]	KURDIA KC, IRRINKI S, CHALA AV, et al. Early intra-abdominal hypertension: A reliable bedside prognostic marker for severe acute pancreatitis[J]. JGH Open, 2020, 4(6): 1091-1095. DOI: 10.1002/jgh3.12393.
[45]	CHENG J, WEI Z, LIU X, et al. The role of intestinal mucosa injury induced by intra-abdominal hypertension in the development of abdominal compartment syndrome and multiple organ dysfunction syndrome[J]. Crit Care, 2013, 17(6): R283. DOI: 10.1186/cc13146.
[46]	SUN J, SUN H, SUN Z, et al. Intra-abdominal hypertension and increased acute kidney injury risk: a systematic review and meta-analysis[J]. J Int Med Res, 2021, 49(5): 3000605211016627. DOI: 10.1177/03000605211016627.
[47]	MALBRAIN ML, de LAET IE, de WAELE JJ, et al. Intra-abdominal hypertension: definitions, monitoring, interpretation and management[J]. Best Pract Res Clin Anaesthesiol, 2013, 27(2): 249-270. DOI: 10.1016/j.bpa.2013.06.009.
[48]	SENDLER M, van den BRANDT C, GLAUBITZ J, et al. NLRP3 inflammasome regulates development of systemic inflammatory response and compensatory anti-inflammatory response syndromes in mice with acute pancreatitis[J]. Gastroenterology, 2020, 158(1): 253-269. e14. DOI: 10.1053/j.gastro.2019.09.040.
[49]	VASSEUR P, DEVAURE I, SELLIER J, et al. High plasma levels of the pro-inflammatory cytokine IL-22 and the anti-inflammatory cytokines IL-10 and IL-1ra in acute pancreatitis[J]. Pancreatology, 2014, 14(6): 465-469. DOI: 10.1016/j.pan.2014.08.005.
[50]	LI JP, YANG J, HUANG JR, et al. Immunosuppression and the infection caused by gut mucosal barrier dysfunction in patients with early severe acute pancreatitis[J]. Front Biosci (Landmark Ed), 2013, 18(3): 892-900. DOI: 10.2741/4150.

Relative Articles

Supplements(0)

Cited By

Proportional views

Proportional views

通讯作者: 陈斌, bchen63@163.com

1.
沈阳化工大学材料科学与工程学院沈阳 110142

Get Citation

PDF

XML

Article Metrics

Article views (453) PDF downloads(82)

Research advances in acute pancreatitis-associated ascites fluid

DOI: 10.3969/j.issn.1001-5256.2023.05.035

Abstract

References

Proportional views

Catalog

通讯作者: 陈斌, bchen63@163.com

Article Metrics

Proportional views

Related

Research advances in acute pancreatitis-associated ascites fluid

DOI: 10.3969/j.issn.1001-5256.2023.05.035

Abstract

References

Proportional views

Catalog

通讯作者: 陈斌, bchen63@163.com

Article Metrics

Proportional views

Related

About Journal

Submission Guideline

Journal Online

Hepatobiliary College

Guidelines

Export File

Citation

Format

Content