重症急性胰腺炎的手术时机和手术方法选择

目的 探讨治疗重症急性胰腺炎（ＳＡＰ）的手术时机和手术方法。方法 分析７８例ＳＡＰ患者的临床资料。结果 手术治疗６７例。经腹腔穿刺抽出血性腹水的患者按双盲法随机分为两组：单纯腹腔置管术组（３５例）。经腹壁向腹腔内置管，手术后采用闭式灌洗。３５例中４例手术后因成人型呼吸窘迫征（ＡＲＤＳ）死亡，３１例存活，其中６例出现假性囊肿；３５例中４例手术后因成人型呼吸窘迫征（ＡＲＤＳ）死亡，３１例存８活，其中６

The timing and procedure of operation for severe acute pancreatitis

Objective To study the timing and procedure of operation for severe acute pancreatitis(SAP). Methods The clinical data of 78 cases of SAP was analysed retrospectively. Results (1) Surgical treatment: 67 cases with abdominal blood liquid were randomly divided into two groups: (a) simple abdominal dranage groups: 35 patients. They were lavaged from the tubes. Four patients with ARDS were dead after operations, others survived; (b) modified operation group: 32 patients. The operation consisted of cholecystectomy, choledochostomy, jejunostomy and great omentum resection; the pancreas was not operated. All of the patients survived. (2) No operation group: 11 patients without any liquid in abdomen were treated with non operation treatment. All of the 11 patients survived. Conclusions The surgical treatment should be performed on the SAP patient with abdominal blood liquid, but the pancreas should not be operated to keep the integrity of pancreas.