The effect of peritoneal lavage with the addition of
camostate to the lavage fluid on the outcome of
taurocholate pancreatitis in rats was studied.
Camostate is a low molecular weight
protease inhibitor which has been developed recently. Peritoneal lavage was performed for 12 hours and
camostate was added to the lavage fluid in five concentrations. At 0.1 mg/ml the survival rate increased significantly (11 of 20 v controls 4 of 20, p less than 0.05); the maximal effect was observed at 0.2 mg/ml, and no effect was seen at 0.01 and 0.05 mg/ml. Adverse effects occurred at 0.5 mg/ml. The addition of 0.1 mg/ml
camostate significantly reduced the
acidosis in arterial blood: mean (SD) pH 7.30 (0.035) v controls 7.23 (0.054) (n = 9, p less than 0.01) and arterial base excess: -15.4 (1.26) mmol/l v controls: -17.4 (2.51) mmol/l (n = 9, p less than 0.05). There was no difference, however, in plasma
amylase activity and in the histological degree of specific tissue damage to the pancreas. A combination of intravenous
camostate and lavage with the addition of
camostate to the lavage fluid yielded a significantly improved survival compared with treatment with intravenous
camostate alone (10 out of 16 animals v intravenous
camostate alone, two out of 16, p greater than 0.01). We conclude that lavage with
camostate significantly improves the prognosis of severe necrotising
pancreatitis in rats.