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In 39 patients with severe attacks of acute pancreatitis, a longitudinal study was done with respect to the influence of peritoneal lavage on objective prognostic signs (WBC, blood-glucose, scrum-calcium, hematocrit, serum-creatininc, arterial pO2, base deficit); amylasc activities in peritoneal fluid, serum, and urine; serum-hemoglobin, serum-Na, serum-K, and plasma-insulin. In addition to standard care in the ICU, half of the patients (N = 19) were randomly treated with peritoneal lavage. Peritoneal lavage did not influence overall mortality (13%), incidence of major complications (36%), or hospital stay (23 ± 7 days). None of the prognostic signs was significantly influenced by lavage. Amylase concentration in peritoneal fluid was significantly reduced in the lavaged group after 6 hours compared to 24 hours in controls. Serum and urinary amylasc decreased 12 hours earlier in the lavaged group, indicating an efficiency of the lavage procedure per-se. Still, this study did not reveal any beneficial clinical effects of peritoneal lavage in acute pancreatitis.