早期手术治疗急性坏死性胰腺炎

EARLY SURGICAL MANAGEMENT OF ACUTE NECROTIZING PANCREATITIS

我院自1985年1月至1992年6月,收治经手术探查和病理证实的急性坏死性胰腺炎34例,其中男10例,女24例,平均年龄43.8岁,手术至发病时间为10～63小时,平均30.7小时。除1例行胰次全切除外,余33例均行胰包膜切开、胰床松动、坏死组织清除术。本组治愈29例,平均住院77.4天;死亡5例,病死率为14.7％。我们认为此病一旦诊断明确,应立即早期手术,坏死组织清除术为简便、易行、安全、有效的手术方式。

From January 1985 to June 1992, 34 patients with acute necrotizing pancreatitis proved by operation and pathology were admitted. The patients consisted of 10 males and 24 females, aged 1～72 with an average age of 43.8years. The time from onset to operation was 10～63 hours (average 30.7 hours). All patients underwent pancreatic capsulotomy, mobilization of pancreatic bed, and necrosectomy with the exception of one treated by subtotal pancreatectomy. Twenty-nine cases were cured, the average hospital stay was 77.4 days. Five patients died with a mortality of 14.7 per cent. We take the view that all patients with acute necrotizing pancreatitis should be early operated when the diagnosis is established, and necrosectomy proved to be a simple, easy, safe and effective mode of operation.