IMPACT OF MICROCIRCULATORY FLOW PATTERN CHANGES ON THE DEVELOPMENT OFACUTE EDEMATOUS AND NECROTIZING PANCREATITIS IN RABBIT PANCREAS

Impairment of pancreatic microcirculation has often been advocated as one pathogenic mechanism in necrotizing pancreatitis. In contrast, dat a on pancreatic capillary perfusion in edematous pancreatitis are scar ce. It was the aim of this experimental study to compare changes in pa ncreatic microcirculation in edematous and necrotizing pancreatitis. T welve rabbits were allocated to two groups. Two different models of ac ute pancreatitis were used. Edematous pancreatitis was elicited by int ravenous administration of cerulein (25 mu g/kg/hr) (N = 6). Necrotizi ng pancreatitis of the biliary type was induced by pressure-controled intraductal infusion of a mixture of taurocholate, trypsin, and blood (N = 6). Pancreatic microcirculation was quantified by means of intrav ital microscopy assessing functional capillary density, blood cell vel ocity, and distribution of the plasma marker FITC-dextran 70. Systemic hemodynamics were maintained at baseline values by fluid administrati on. Regardless of edema or necrosis, pronounced extravasation of FITC- dextran was recorded in the early stage of pancreatitis: In cerulein-i nduced pancreatitis, hyperemia developed as indicated by an increase i n blood cell velocity in the presence of homogeneous capillary perfusi on. In contrast, a progressive reduction of the number of perfused cap illaries was detected in necrotizing pancreatitis. In conclusion, panc reatic microvascular perfusion may be regarded as an important pathoge netic factor for the determination of acute pancreatitis.