重症急性胰腺炎并发胰腺脓肿和胰腺坏死的外科治疗

Surgical treatment of patients with severe acute pancreatitis complicated pancreatic necrosis and pancreatic abscess

目的 探讨重症急性胰腺炎并发感染性胰腺炎坏死 (IPN )和胰腺脓肿 (PA)的外科治疗。方法 12例IPN和 3例PA病人均采取手术方法治疗 ,清除胰腺脓肿、坏死组织和胰腺周围坏死组织 ,并行腹腔灌洗和引流。结果 11例IPN病人和 3例PA病人痊愈出院 ,1例IPN历经 4次手术并发腰椎感染和骨质破坏 ,另 1例IPN痊愈后 1年又复发 ,已经 2次手术 ,现正在恢复中。结论 IPN和PA是重症急性胰腺炎的最严重并发症 ,影像学检查显示胰腺或周围存在难消退的积液时 ,应积极行手术治疗 ,彻底清除感染坏死组织并加局部灌洗和引流。

Objective To investigate surgical treatment methods of the patients with severe acute pancreatitis complicated pancreatit necrosis (IPN) and pancreatic abscess (PA). Methods The operation of removing pancreatic abscess,infected necrosis tissues in the pancreas and peripancreatic tissues were performed. Additional, abdominal cavity infusion and drainage also were performed.Results 12 patients with IPN and 3 patients with PA were cured. Four times of operation was performed in a paitents with IPN and his corpus vertebras are infected and destructed. Another patients was relapsed after 1 year and was again performed 2 times of operation. The patient is in the stage of recovery.Conclusions IPN and PA are severe complications of severe acute pancreatitis. If image examination were showed that hydrops could not be extincted in the pancreas and peripancreas, operative therapy should be performed.