FASTING INCREASES THE SEVERITY OF ACUTE PANCREATITIS: IMPLICATIONS IN PREOPERATIVE INTERVENTIONS TO REDUCE PANCREATIC PROCEDURES COMPLICATIONS
Marcel C C. Machado*, suely Ariga, maria l. souza, Denise F. Barbeiro, Heraldo P. Souza
University of São Paulo Faculty of Medicine, São Paulo, Sao Paulo, Brazil
Backgrounds
Most patients with postoperative acute pancreatitis have a benign course however, in some patients, pancreatic inflammation may compromise the results mainly of pancreatic procedures with increased complications and even death.
Several prophylactic measures have been proposed in order to reduce the severity of postoperative pancreatitis and therefore the incidence of complications as pancreatic fistulas mainly in pancreaticoduodenectomy. However there is no study related to the influence of the duration of preoperative fasting on the severity of postoperative pancreatitis
Aim: The aim of this study was to determine if the duration of fasting influences the severity of acute pancreatitis. In clinical practice the results of this experimental study may influence the duration of preoperative fasting period in pancreatic procedures
Methods: Animals were divided into 4 groups: Group CTF(n=5) control fasting for 24 h with free access to water; Group CTNF (n=5) control nonfasted animals with free access to food and water; Group APF (n=7) fasted for 24h and submitted to laparotomy and induction of acute pancreatitis (AP) and Group APNF (n=7) non fasted group submitted to laparotomy and induction of AP
AP was induced in Male C57black/6 mice (six to 8 week-old) weighting 20-25g by an intraductal 1.5 % taurocholate injection. Eight hours after AP blood was collected for evaluation of cytokine: IL-1beta, IL-6, IL-10, TNFalfa and MCP-1.Liver tissue was collected for the determination of TBARs/MDA and pancreas tissue collected for determination of enzyme content. Results: It was observed an increased pancreatic amylase content in fasting animals as well as increased levels of serum IL-6, Il-10 and MCp-1 in AP fasting animals, Liver MDA was also elevated in AP fasting animals
Conclusion: In the present study in a model of severe acute pancreatitis we could observe an increase in the severity of acute pancreatitis with prolonged fasting.These results point to a reduction of the fasting preoperative period before pancreatic procedures in clinical practice
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