【摘要】 目的　探讨重症胆源性胰腺炎 (GP)的手术时机。方法　对 1 995年 1月～ 1 999年 1 2月收治的 30例明确诊断为重症GP患者延期手术和病死率进行系统的回顾性分析。结果　 2例因梗阻性化脓性胆管炎早期急诊手术 ,术后 1例死于心衰。非手术治疗过程中 1例死于多器官功能衰竭。延期手术 2 7例 ,2例分别死于多器官功能衰竭和真菌性败血症。术后并发症 2例 ,分别是胰瘘和胰周残余脓肿。延期手术病死率和并发症发生率分别是 1 0 .0 %、6 .7%。结论　重症GP应首先行非手术治疗 ,待渡过急性期 ,一般于起病 3周后在同一住院期间延期手术 ,若非手术治疗过程中出现梗阻性化脓性胆管炎、胰腺坏死组织并发感染 ,应早期急诊手术。延期手术能保证较低的病死率更多还原

【Abstract】 Objective To investigate the timing and indications of surgical management in the patients with severe gallstone pancreatitis. Methods The delayed surgery and mortality were reviewed retrospectively in 30 cases of severe gallstone pancreatitis undergoing laparotmy in our hospital from 1995 to 1999.Results Of the 2 cases of suppurative obstructive cholangitis receiving early emergency operation, one died of heart failure. During the medical treatment, one case died of multiple organ faiure. Of the 27 patients receiving delayed operation, 2 cases died of multiple organ failure and fungal septicemia respectively. Postoperative complications occurred in 2 cases. The overall mortality and occurrence of complications for delayed surgery was 10.0% and 6.7% respectively. Conclusion The delayed surgery for severe gallstone pancreatitis was done after 3 weeks of admission. Early emergency operation should be done unless infection of pancreatic necrosis and acute obstructive suppurative cholangitis occurred. Delayed surgery had a low mortality.更多还原