21例胰腺脓肿的治疗

目的 探讨胰腺脓肿的外科治疗。方法 回顾性分析21例重症急性胰腺炎并发胰腺脓肿的临床治疗资料，脓肿数目1～7个，直径3．2～11．7cm，所有病人均经手术清除脓肿及胰腺坏死组织，并行引流及腹腔灌洗。结果 19例痊愈出院，2例合并多器官功能衰竭死亡，3例并发胰瘘，7例脓肿复发再次手术(其中1例行5次手术，2例行3次手术)。结论 胰腺脓肿是重症急性胰腺炎的严重并发症，明确诊断后应立即手术治疗，术中尽可能清除坏死组织并根据具体情况决定引流管的大小、数量及放置部位，保持充分有效的引流至关重要。

SURGICAL TREATMENT OF PANCREATIC ABSCESSES:A REPORT OF 21 CASES

Objective To investigate the surgical treatment of the pancreatic abscesses.Methods The clinical data of 21 cases with pancreatic abscesses were retrospectively analyzed.The number and diameter of abscesses rangeed from 1 to 7 and 3.2 cm to 11.7 cm.respectively.All patients underwent debirdement and drainage.Results 19 patients cured.2 patients died of MSOF.Pancreatic fistula occurred in 3 patients.Abscesses relapsed in 7 patients and re explorated(one of them have five exploration and 2 have three exploration).Conclusion Pancreatic abscesses are severe complications of acute necritizing pancreatitis.Surgical treatment must be performed immediately when diagnosis is determined.Abscesses and necrotic tissue should be debrided well.The number of drainage tube and location of its placement can be determined at the operation.Keeping drainage tube smooth is very important.