TRYPSINOGEN ACTIVATION PEPTIDES (TAP) CONCENTRATIONS IN THE PERITONEAL-FLUID OF PATIENTS WITH ACUTE-PANCREATITIS AND THEIR RELATION TO THE PRESENCE OF HISTOLOGICALLY CONFIRMED PANCREATIC NECROSIS

This study measured the volume and colour, as well as concentrations o f trypsinogen activation peptides (TAP) in the peritoneal fluid of 22 patients with acute pancreatitis and related these findings to the pre sence of pancreatic necrosis. Nine patients had a severe attack with h istologically confirmed pancreatic necrosis, seven a severe attack wit hout confirmed necrosis, and six a mild attack, also without confirmed necrosis. A free fluid volume >20 ml or free fluid colour >grade 5 on the Leeds chart, or both detected histologically confirmed pancreatic necrosis with a sensitivity of 100% and specificity of 31%. A total p eritoneal fluid TAP concentration of greater than or equal to 96 nmol detected histologically confirmed pancreatic necrosis with a sensitivi ty of 89% and specificity of 85%, figures comparable with contrast enh anced computed tomography. These findings suggest that the measurement of fluid TAP concentrations can detect effectively histologically con firmed pancreatic necrosis and that such measurements may prove useful in the selection of patients for surgery.