重症急性胰腺炎手术时机及手术方式的探讨

Choice of chance and mode of operation in severe acute pancreatitis

目的 探讨重症急性胰腺炎的手术时机及手术方式。方法 总结重症急性胰腺炎 72例 ,其中保守治疗 42例 ,手术治疗 30例。手术采取胰腺包膜切开 ,坏死灶清除 ,胰床松解 ,多管引流及术后充分胰腺冲洗。结果保守治疗重症Ⅰ级 39例 ,死亡 1例 ;重症Ⅱ级 3例 ,死亡 1例。手术治疗重症Ⅰ级 6例 ,均治愈 ;重症Ⅱ级 2 4例 ,死亡 4例。结论 重症急性胰腺炎有胰腺感染和并发症者行手术治疗 ,其余的患者则行积极的保守治疗。

Objective To study choice of chances and mode of operations in severe acute pancreatitis (SAP). Methods 72 patients with SAP were grouped for conservative or surgical treatment. The main components of operations were elimination of necrostic lesion, lysis of the pancreas, multiple drainage, and adequate postoperative peritoneal lavage. Results Conservative treatment was adopted in 42 patients (39 patients in Grade Ⅰ,3 in GradeⅡ),among them 40 recovered, and 2 died. 30 patients underwent surgical treatment including 6 in GradeⅠ,24 in Grade Ⅱ,26 patients were cured,4 patients of Grade Ⅱ died. Conclusion Operations were performed on patients with pancreatic infection and complications. Non operative treatment was administered to other patients.