Continuous Regional Arterial Infusion of Low Molecular Weight Heparin in Patients With Severe Acute Pancreatitis (CRAI-H)

• coagulation related complications [ Time Frame: 14 days after the placement of celiac trunk catheter ] [ Designated as safety issue: Yes ]

  bleeding for the most

  coagulative parameters

• Pancreatic infection [ Time Frame: 28 days ] [ Designated as safety issue: No ]

• coagulation related complications [ Time Frame: 14 days after the placement of celiac trunk catheter ] [ Designated as safety issue: Yes ]

  bleeding for the most

  cogulative parameters

• Mortality [ Time Frame: Participants will be followed until the date of discharge or the date of death from any cause, whichever came first, assessed up to 3 months ] [ Designated as safety issue: No ]

• pancreatic necrosis [ Time Frame: 28 days ] [ Designated as safety issue: No ]
• ICU duration [ Time Frame: Participants will be followed until the date of discharge from the ICU,assessed up to 6 weeks. Patients who die during hospitalization are excluded from this measurement. ] [ Designated as safety issue: No ]
• Hospital duration [ Time Frame: Participants will be followed until the date of discharge from the hospital,assessed up to 3 months. Patients who die during hospitalization are excluded from this measurement. ] [ Designated as safety issue: No ]
• Mortality [ Time Frame: Participants will be followed until the date of discharge or the date of death from any cause, whichever came first, assessed up to 3 months ] [ Designated as safety issue: No ]

• pancreatic necrosis [ Time Frame: 28 days ] [ Designated as safety issue: No ]
• Pancreatic infection [ Time Frame: 28 days ] [ Designated as safety issue: No ]
• ICU duration [ Time Frame: Participants will be followed until the date of discharge from the ICU,assessed up to 6 weeks. Patients who die during hospitalization are excluded from this measurement. ] [ Designated as safety issue: No ]
• Hospital duration [ Time Frame: Participants will be followed until the date of discharge from the hospital,assessed up to 3 months. Patients who die during hospitalization are excluded from this measurement. ] [ Designated as safety issue: No ]

Our animal studies found that continuous regional arterial infusion (CRAI in the celiac trunk) of low molecular weight heparin (LMWH) could alleviate inflammation, improve global hemodynamics and restore organ function in a porcine model of severe acute pancreatitis (SAP,unpublished).

In this study, the investigators aim to evaluate the effects of CRAI of LMWH in the treatment of SAP patients. The investigators suppose CRAI could help improve the outcomes of these patients.

• Procedure: Continuous regional arterial infusion of low molecular weight heparin in celiac trunk
  Put a catheter to the celiac trunk through interventional technique. The approach to celiac trunk was via a femoral artery approach.The tip of the arterial catheter (4F) was placed in celiac trunk which could perfuse the pancreas.After that, continuous infusion of low molecular weight heparin through the catheter will be applied during the first 5 days after placement.
• Other: General treatment
  Include fluid resuscitation, percutaneous drainage if needed, antibiotics,organ support, etc.

• Experimental: CRAI
  CRAI of LMWH in the celiac trunk
  Interventions:

  • Procedure: Continuous regional arterial infusion of low molecular weight heparin in celiac trunk
  • Other: General treatment
• Conservative treatment
  Conservative treatment without CRAI, control group
  Intervention: Other: General treatment

Inclusion Criteria:

• Symptoms and signs of severe acute pancreatitis according to Atlanta criteria
• Within 3 days from the onset of the disease
• Available for interventional treatment(not sensible to radiocontrast agent)

Exclusion Criteria:

• Pregnant pancreatitis
• Receiving surgery or aspiration before;need of early surgery
• Patients with coagulation disorders