"What Medications Can Be Used to Treat Pancreatitis?"

After contracting pancreatitis, patients may experience symptoms such as nausea, vomiting, fever, and abdominal pain. Acute pancreatitis can potentially lead to shock, posing significant harm. For patients with pancreatitis, the desire is undoubtedly to resolve this condition as soon as possible through medication. Therefore, the medications used to treat pancreatitis become a matter of great concern. So, what are the medications for treating pancreatitis? Let's take a look below.

What are the medications for treating pancreatitis?

Firstly, to prevent and treat shock and improve microcirculation, it is essential to actively supplement fluids, electrolytes, and calories to maintain circulatory stability and water-electrolyte balance. Secondly, methods to inhibit pancreatic secretion are employed. For severe acute pancreatitis, somatostatin or its long-acting analog octreotide is administered at a dose of 0.1mg every 6 hours for 3 to 7 consecutive days. For acute mild (edematous) pancreatitis or acute hemorrhagic necrotizing pancreatitis, gabexate mesilate, an inhibitor of pancreatic enzymes, can be used. Initially, 300mg is given daily for 3 days, followed by 100mg daily via intravenous drip after symptom improvement, dissolved in 500ml of 5% glucose injection at a drip rate of 1mg per minute for 6 to 10 consecutive days. For hemorrhagic necrotizing pancreatitis, aprotinin, a trypsin inhibitor, can be given at 80,000 to 120,000 units on the first to second day of onset, dissolved in 20ml of 0.9% sodium chloride or 25% glucose injection and administered via slow intravenous injection at a rate of 2ml/min. The maintenance dose is 20,000 to 40,000 units per day, divided into 4 doses. Thirdly, for spasmolysis and pain relief, analgesics should be administered regularly. The traditional method involves intravenous infusion of 0.1% procaine for venous blockade. Additionally, pethidine can be used in combination with atropine at regular intervals to relieve pain and relax the Oddi sphincter, with morphine being contraindicated to avoid inducing Oddi sphincter spasms. Nitroisopentyl and nitroglycerin can also be used in cases of severe pain, particularly for elderly patients, as they can relieve Oddi sphincter spasms and benefit coronary blood supply. Fourthly, nutritional support is crucial in acute severe pancreatitis due to the body's high catabolic state, inflammatory exudation, prolonged fasting, and high fever, leading to negative nitrogen balance and hypoproteinemia. Nutritional support must be provided while minimizing pancreatic secretion. Fifthly, the use of antibiotics is an indispensable part of comprehensive treatment for acute pancreatitis. The use of antibiotics in acute hemorrhagic necrotizing pancreatitis is uncontroversial. In acute edematous pancreatitis, a reasonable amount of antibiotics should be used as a preventive measure against secondary infections.

Surgical Methods for Treating Pancreatitis

Pancreatic abscess, pancreatic pseudocyst, and pancreatic necrosis complicated by infection are life-threatening complications of acute pancreatitis. Surgical intervention is indicated in cases of uncertain diagnosis, secondary pancreatic infection, concomitant biliary diseases, or continued clinical deterioration despite reasonable supportive treatment. The main surgical options for severe cases include: 1) laparotomy to debride necrotic tissue and place multiple drainage tubes for continuous postoperative irrigation, followed by closure of the incision; 2) laparotomy to debride necrotic tissue with partial open drainage of the wound. During the procedure, gastrostomy, jejunostomy (for enteral nutritional support), and biliary drainage may be performed simultaneously. Percutaneous catheter drainage can be used for isolated abscesses or infected pancreatic pseudocysts. In severe biliary pancreatitis with impacted stones in the ampulla of Vater, concomitant biliary obstruction or infection, emergency surgery or early surgery (within 72 hours) is required to relieve biliary obstruction, remove stones, and establish unobstructed drainage. Depending on the patient's condition, cholecystectomy or pancreatic drainage in the lesser omental sac may be performed. When feasible, endoscopic sphincterotomy with stone removal via a fiberoptic duodenoscope can be highly effective with few complications. Chronic pancreatitis requires treatment of the underlying cause, such as addressing biliary diseases and abstaining from alcohol. Dietary therapy involves small, frequent meals with high protein, high vitamin, and low-fat content. Pancreatic enzyme supplements, diabetes control, and nutritional support therapy are also important. When necessary, pancreatic duct drainage and pancreatic surgery may be performed.