胆源性急性胰腺炎手术方式及时机的选择

Operation method and time's selection in treating acute biliary pancreatitis

目的探讨胆源性急性胰腺炎(ABP)手术方式及时机的选择。方法回顾性分析118例ABP患者的临床资料,比较治愈率、并发症、APACHEⅡ计分等。结果一次治愈率为92.37%,总治愈率为95.76%,死亡率4.24%;除急性轻症ABP外,其他各型早期手术的愈后相对较好,延期手术的并发症相对增加(P<0.05)。重症胆源性胰腺炎和暴发性胰腺炎时延期手术的并发症和死亡率明显增加,与急性轻症ABP比较,差异均具有统计学意义(P<0.05)。结论 24～48 h的短期综合治疗后,行早期手术治疗,是治疗ABP的关键,可提高ABP的治愈率。

Objective To explore the operation method and time＇s selection in treating acute biliary pancreatitis （ABP）. Methods A total of 118 cases with ABP were retrospectively analyzed to compare their cure rate, complication and APACHE II＇s score. Results Primary cure rate was 92.37%, and total cure rate was 95.76%, yet mortality was 4.24%. Except for acute light ABP, early surgery of other various had good effect, and delay surgery＇s complications increased （P 〈 0.05）. Complications and mortality in delay surgery of severe ABP and fulminant ABP increased signif- icantly, and there were statistical differences on comparing with acute light ABP （P 〈 0.05）. Conclusion It is the key to treat ABP by early surgery after 24-48 h short-term comprehensive treatment, and it can improve ABP＇s cure rate.