Indication and timing for operation in severe acute pancreatitis / 中国普通外科杂志

ABSTRACT

Objective To investigate the indication an d timing for operation in severe acute pancreatitis. M ethod The clinical data of 213 patients with severe acute pancr eatitis treated in our hospital were analyzed. Resul ts Fifty two cases of severe biliary pancreatitis were treated operatively with survival rate of 92%, in which the death cases had a mean su rvival time of 31 days. 43 cases were treated nonoperatively with survival rate of 88%, in which death cases had a mean survival time of 3 days. Sixty five case s of non-biliary pancreatitis were treated operatively with survival rate of 75 %, in which the death cases had a mean survival time of 56 days. 56 cases were treated nonoperativly with survival rate of 89%, in which the death cases had a mean survival time of 8 days.Conclusion (1)Pancreatitis with biliary obstruction should be treated by urgent surgery, in those with infected necrosis a surgery is also indicated.(2) In no n-biliary pancreatitis, nonoperative therapy should be adopted unless there is a sign o f severe peritonitis. Moreover, patients with rapid deteriorated clinical condit ions should undergo exploration. (3) Localized infected necrosis is indicated fo r operation.