Effects of early peritoneal puncture and catheter drainage on severe acute pancreatitis / 中华普通外科杂志

ABSTRACT

ObjectiveTo evaluate the effect on organ function by early peritoneal puncture and catheter drainage for intra-abdominal hypertension during the course of severe acute pancreatitis (SAP).MethodsA retrospective study was conducted on 405 patients of severe acute pancreatitis with IAH at Department of Pancreatic Surgery,Wuhan Union Hospital from January 2001 to September 2010.In the early course of SAP,137 cases did not receive peritoneal puncture and drainage decompression,268 cases were treated with peritoneal puncture and drainage decompression.ResultsThe differences of the scores of UBP and APACHE Ⅱ were statistically significant between the puncture group and the non-puncture group (P ＜ 0.05).The occurrence of ARDS,ARF and MODS in the group of puncture were significantly lower than those of the non-puncture group (14％ vs.27％,21％ vs.32％,9％ vs.14％,respectively,all P ＜0.05 ).At the same time,the differences between rate of early laparotomy and rate of early mortality in the two groups were statistically significant (4％ vs.12％,3％ vs.6％,respectively,all P ＜0.05).However,there was no significant difference in the occurrence time of negative balance in the two groups (5.9 ±2.9 vs.5.9 ± 2.4,P ＞ 0.05 ).ConclusionsEarly abdominal puncture and drainage reduce the abdominal pressure of patients with SAP and IAH.It also reduces the occurrence of organ failure,the rate of early laparotomy and the rate of early mortality in SAP patients.