急性胆源性胰腺炎外科手术时机的探讨

Study on the Operation Opportunity of Severe Acute Biliary Pancreatitis

目的探讨急性胆源性胰腺炎(acute biliary pancreatitis,ABP)的手术时机,降低术后病死率。方法对116例ABP患者的手术时机、治愈率、并发症的发生率及病死率等进行分析。结果发病72h内手术治疗11例,治愈2例,并发症5例,死亡4例;发病后72h至2周手术27例,治愈21例,并发症4例,死亡2例;发病2周至2月手术35例,治愈32例,并发症3例,无死亡。发病2月后手术43例,无并发症和死亡。经统计学分析,不同手术时间治愈率、并发症的发生率、病死率差异有统计学意义(P<0.01)。结论ABP的手术时机是影响手术后病死率的重要因素,应采用个体化治疗原则。

Objective To investigate the operation opportunity of acute biliary pancreatitis （ABP）and to reduce postoperative mortality. Methods The operation opportunity, the cure rate, relapse rate and mortality rate were analyzed in 116 patients with the ABP. Results Of 11 patients received surgical operations within 72 hours after the onset, 2 cases were cured, 5 cases had complications,4 cases died; of 27 patients received surgical operations from 72 hours to two weeks after onset,21 cases were cured ,4 cases had complications ,2 cases died ;35 patients received surgical operations from two weeks to two months onset,32 cases were cured ,3 cases had complications, no cases died ;42 patients received surgical operations after two months onset, no case had complications or died. The curative rate, the incidence of complications and mortality had significantly difference in dif- ferent operation opportunity group. Conclusion The operation opportunity is one of the most important factors impact the mortality of ABP. The principle of individual treatment is of importance.