ABSTRACT
Objective To explore the therapeutic principle and method for severe acute pancreatitis(SAP). Methods The treatment data from 102 cases with SAP in our department from 1990 to 2000 were analyzed retrospectively. Results Twenty two patients with SAP accompanied by biliary tract obstruction underwent surgical treatment with a healing rate of 91% and a death rate of 9%. In the 38 cases of SAP with biliary stone but without biliary tract obstruction, 20 patients underwent surgical treatment with a healing rate of 95% and a death rate of 5%, but 18 patients received non surgical treatment with the healing rate of 100%. Of the 42 cases of non biliary SAP, 23 patients underwent surgical treatment with a healing rate of 70% and a death rate of 30%, but 19 patients underwent non operative treatment with a healing rate of 84% and a death rate of 16%. Conclusion Patients with SAP accompanied by biliary tract obstruction should receive emergency operation, but those with SAP accompanied by biliary stone but without biliary tract obstruction should receive non operative treatment first. The surgical indications for non biliary SAP should be strictly controlled.