In a first in the world, the Department of Surgical Gastroenterology in the PGI History published a path-breaking study that has established the role of streptokinase in the management of the dreaded disease of severe acute pancreatitis.

Detailing about the study, Rajesh Gupta, Professor and Head, Department of Surgical Gastroenterology, said, "Streptokinase has been used since early 1960s for dissolution of intravascular thrombosis in pulmonary thromboembolism, myocardial infarction and deep vein thrombosis. "The Department of Surgical Gastroenterology in close collaboration with the Department of Medical Gastroenterology started off-label use of streptokinase in 2013. The idea to use streptokinase in patients of severe acute pancreatitis was conceptualised after we observed its successful use in chest collections by pulmonologist".

Gupta further elaborated, "We first conducted experimental work in 2013 to look at the effect of streptokinase on pancreatic necrosis removed at the time of surgery and results were heartening. "This encouraged us to use streptokinase in two patients who were critical and not fit for surgery. We observed that the addition of streptokinase in irrigation fluid in the abdominal drain led to gradual improvement in their clinical condition and both the patients recovered without the need of surgery. "We published this work in a top journal of pancreatic disease in 2014 namely, Pancreatotology". After this initial success, we planned the first study in 2015 and subsequently did three more studies including two M.Ch theses in surgical gastroenterology in collaboration with medical gastroenterology and radiology. We combined data from four studies and published results in one of the top surgical journals namely Surgery", said Gupta.

Attributing the success to the commitment and perseverance of the team comprising of Surinder Rana, Mandeep Kang, Ujjwal Gorsi,A Ritambra Nada and all other senior and junior residents involved in the study, Gupta threw light on the results as he shared, "Results by our study have clearly shown that there was a significant decrease in the need of surgery with the use of streptokinase and there was no increase in complications with its use which was major apprehensions. "Ours is the first large study involving more than 100 patients where streptokinase has been proven efficacious in the management of severe pancreatitis with infected necrosis. We have observed that results of streptokinase were better with higher doses". Gupta added, "We have recently completed another study where we have compared the use of streptokinase with another agent i.e. hydrogen peroxide and found encouraging results with streptokinase.

"This study is at present under consideration of another prominent journal. Now, we are planning a bigger study involving various Surgical and Medical Gastroenterology Departments in different parts of the country. This is the first time in the world that streptokinase has been found to be a useful adjunct in the management of severe acute pancreatitis". It is important to emphasise that the Department of Surgical Gastroenterology and Medical Gastroenterology are top departments in the country in the management of severe pancreatitis with a lot of research happening to reduce the complications and deaths in this dreaded disease", said Gupta.