急性胆源性胰腺炎手术时机的选择

OPERATION TIMING FOR ACUTE GALLSTONE PANCREATITIS(40 CASES REPORT)

目的 探讨急性胆源性胰腺炎手术时机的选择。方法 回顾性分析4 0例急性胆源性胰腺炎的临床资料。结果 2 3例急性非梗阻性胆源性胰腺炎中,14例经非手术治疗症状缓解后1至2周内行延期手术;9例因高热或腹腔感染行急诊手术,2例死亡(病死率为2 2 .2 % )。17例急性梗阻性胆源性胰腺炎先行非手术治疗,9例在2 4至4 8小时后症状不缓解行急诊手术,8例在症状缓解后1至2周内行延期手术,皆治愈。结论 急性非梗阻性胆源性胰腺炎早期应选择非手术治疗,症状缓解后延期手术。早期手术死亡率高。急性梗阻性胆源性胰腺炎在非手术治疗2 4至4 8小时症状不缓解则急诊手术。

Objective To investigate the operation timing acute gasstone pancreatitis.Methods To analyze the clinical data of 40 cases retrospectively.Result Aomng the 23 patients with acute non-obstructive gasstone pancreatitis,14 patients underwent delayed operation after the conservatie therapy took effect in 1～2 weeks,9 patients underwent emergency operation because of fever or peritoneal infection,2 patients died(22.2%).Among the 17 patients with acute obstructive gallstone pancreatitis,9 patients underwent early emergency operation when the conservative therapy was effectless in 24～48 hours,8 patients underwent delyed operation after the conservative therapy took effect in 1～2 weeks,All patients were cured.Conclusion The patients with acute non-obstructive gallstone pancreatitis should undergo conservative therapy at first and then delayed operation were performed,the mortality of early procedure was higher.Early emergency operation should be performed to treat acute obstructive gallstone pancreatitis when the conservative therapy took no effect in 24-48 hours.