The value of early interventional ultrasound technology in the treatment of severe acute pancreatitis

Objective To explore the clinical effect of early contrast-enhanced ultrasound (CEUS)-guided interventional procedures on patients with severe acute pancreatitis (SAP).

Methods A total of 80 SAP patients were divided into an observation group and a control group according to the admission time, with 40 patients in each group. Patients in the observation group underwent CEUS assessment and subsequent percutaneous catheter drainage within 48 hours of hospital admission, whereas those in the control group received the same interventions after a delay of at least 48 hours. Primary endpoints included time to normalization of body temperature, time to marked improvement in abdominal pain and distension, and time to resolution of nausea and vomiting. Secondary outcomes comprised changes in disease severity scores—including the acute physiology and chronic health evaluation Ⅱ (APACHE-Ⅱ) and bedside index for severity in acute pancreatitis (BISAP)—assessed at baseline and one week post-intervention. Additionally, serial measurements of peripheral blood inflammatory markers—white blood cell count (WBC), C-reactive protein (CRP), procalcitonin (PCT), heparin-binding protein (HBP), interleukin-6 (IL-6)—and serum calcium (Ca²⁺) were obtained at three predefined time points: baseline (T₀), day 4 post-CEUS-guided intervention (T₁), and day 7 post-intervention (T₂).

Results The observation group exhibited significantly shorter durations for normalization of body temperature, relief of abdominal pain, and improvement of abdominal distension compared to the control group (P ＜ 0.05 to P ＜ 0.01), whereas no statistically significant difference was observed in the time to resolution of nausea and vomiting between the two groups (P ＞ 0.05). One week after treatment, both groups showed reductions in APACHE-II and BISAP scores (P ＜ 0.01), with a more pronounced decrease in the observation group (P ＜ 0.05). From T₀ to T₁ and from T₁ to T₂, serum levels of inflammatory markers (WBC, CRP, PCT, HBP, IL-6) decreased (P ＜ 0.05 to P ＜ 0.01), while serum Ca²⁺ levels increased (P ＜ 0.05 and P ＜ 0.01) in both groups. Further analysis of the magnitude of changes revealed that the observation group had a greater reduction in WBC, CRP, PCT, HBP, and IL-6 levels, as well as a greater increase in Ca²⁺ levels, from T₀ to T₁ compared to the control group (P ＜ 0.05 to P ＜ 0.01). From T₁ to T₂, the observation group also showed a more significant decrease in WBC, PCT, HBP, and IL-6 levels (P ＜ 0.05 to P ＜ 0.01), but no significant differences were found in the reduction of CRP or the increase in Ca²⁺ between the two groups (P ＞ 0.05).

Conclusions Early application of CEUS-guided intervention can improve the clinical symptoms of SAP patients, reduce the levels of peripheral blood inflammatory factors WBC, PCT, HBP, and IL-6, alleviate the inflammatory response in SAP patients, and benefit patient prognosis.