急性坏死性胰腺炎的手术时机及手术指征

急性坏死性胰腺炎（ＡＮＰ）的手术时机及手术指征仍存争议。作者对该院１９８５年以来手术治疗的１１９例ＡＮＰ患者进行分析。将发病２周以内手术者定为早期手术，２周以后手术者为晚期手术。发现早期手术病例术中病理所见多为局灶性坏死（占７５．６％），术后并发症以循环及胰外脏器功能紊乱为主，术后死亡率达２８．２％；而晚期手术者多系全胰坏死型（占５３．７％），术后并发症以胰周局部脏器病变为主，死亡率降至１２．３％。因此作者认为ＡＮＰ应尽可能采用晚期手术，并对早期及晚期手术的指征进行了讨论。

Indications for operation in patients with acute necrotizing pancreatitis

The opportunity of and indications for operation in patients with acute necrotizing pancreatitis (ANP) are still controversial.One hundred and ninty surgical cases of ANP were analyzed.Early operation was performed in 2 weeks from onset,and late operation after 2 weeks.In the early operation,the pancreatic sporadic focal necrosis was found in most cases (75 6%),and main postoperative complications were disturbance of blood circulation and organic function injury of pancreas.The postoperative mortality rate was 28 2%. In the late operation,extensive fusional pancreatic necrosis was found in most cases (53 7),and most complications were located in the organs mear the pancreas. The authors conclude that late operation is better for the treatment of ANP.The indications of early and late operation were discussed.