重症胰腺炎手术时机与手术方式选择的探讨

目的探讨重症胰腺炎(SAP)的最佳手术时机和手术方式。方法统计分析68例SAP患者的手术时机、术式及病死率等临床资料。结果早期手术组(入院24 h内)及延期手术组(入院后3~7 d)并发症发生率分别为48.6%和12.9%,两组比较差异具有统计学意义(P<0.01)。术式以胆胰联合手术及单纯胰病灶清除引流为主。结论SAP手术时机是影响手术病死率的重要因素,最佳时机的选择应与SAP自然病程相适应,应待急性发作缓解后延期手术,避免在发病后1~3 d,尤其在入院12 h内手术。术式选择应以简单有效、充分引流、清除病灶、去除病因为基本原则。

Severe Pancreatitis Surgical Timing and Choice of Surgery

Objective The purpose of severe acute pancreatitis(SAP) the best timing and surgery.Methods SAP statistical methods for analyzing the timing of surgery in 68 cases,surgical procedures and mortality clinical data.Results Surgical treatment(24 admission) and the delayed surgery group(3~7 days after admission),the complication rate of 48.6% and 12.9%,respectively(P<0.01).Cholangiopancreatic joint operation to operation and simple drainage of the main pancreatic debridement;Conclusions SAP timing is an important factor affecting mortality,with the best selection of SAP naturally suited to the course,should be deferred after surgery to ease acute avoid the first three days after onset,particularly in the hospital within 12 hours operation.The choice of operative procedure should be simple,efficient,adequate drainage to remove lesions removed because the basic principles of the disease.