Potentiële rol voor probiotica bij de preventie van infectieuze complicaties tijdens acute pancreatitis

- Acute pancreatitis has a high mortality in case of secondary infection of (peri-)pancreatic necrosis.

- Bacterial translocation is held responsible for the majority of these infectious complications of severe acute pancreatitis.

- Prophylactic strategies should therefore be directed at the three most important pathophysiological mechanisms of bacterial translocation: disturbed small-bowel motility and bacterial overgrowth, failure of the mucosal barrier function and a disturbed response of the immune system.

- In-vitro studies and research in experimental animals have shown that specially selected probiotics exert an effect on these mechanisms and can prevent bacterial translocation.

- Recently, several randomised, double-blind, placebo-controlled trials evaluating prophylactic treatment with enteral probiotics have shown good results. A Dutch multicentre trial, ‘Probiotics in pancreatitis trial’ (PROPATRIA), is currently underway.

Ned Tijdschr Geneeskd. 2006;150:535-40