CAJ | 학술논문

目的为提高重症胆源性胰腺炎(SGP)的治疗效果，探讨SGP早期手术适应证和最佳手术时间。方法采用统计学方法回顾性分析52例SGP的手术时机与并发症及死亡情况。结果早期手术(住院48 h内)22例和延期手术(病情稳定6～8周后)30例的并发症的发生率分别为31.8%和3.3%(P<0.025)，病死率分别为13.6%和0(P<0.05)；胆总管探查率分别为90.9%和56.7%(P<0.01)。结论SGP的手术时机应采用延期与个体化相结合的处理原则，即首先应积极系统的非手术治疗，在临床症状控制6～8周后延期手术，能够降低SGP的病死率、并发症和胆总管探查率。在出现以胆道梗阻为主，胰腺炎进行加重或有重症急性胆管炎表现或并发弥漫性腹膜炎时应早期手术治疗为宜。
목적위제고중증담원성이선염(SGP)적치료효과，탐토SGP조기수술괄응증화최가수술시간。방법채용통계학방법회고성분석52례SGP적수술시궤여병발증급사망정황。결과조기수술(주원48 h내)22례화연기수술(병정은정6～8주후)30례적병발증적발생솔분별위31.8%화3.3%(P<0.025)，병사솔분별위13.6%화0(P<0.05)；담총관탐사솔분별위90.9%화56.7%(P<0.01)。결론SGP적수술시궤응채용연기여개체화상결합적처리원칙，즉수선응적겁계통적비수술치료，재림상증상공제6～8주후연기수술，능구강저SGP적병사솔、병발증화담총관탐사솔。재출현이담도경조위주，이선염진행가중혹유중증급성담관염표현혹병발미만성복막염시응조기수술치료위의。
ObjectiveTo explore the early surgical indication and optimal operation timing in patients with severe gallstone pancreatitis (SGP) for the purpose of improving its therapeutic effects. Methods A retrospective analysis on optimal operation timing , complications and mortality of 52 SGP patients admitted from Jan.,1995 to May 2000 was done by statistical methods.. Results Twenty-two cases were operated at early stage (within 48 hr after admission); 30 cases at delayed stage (6～8 weeks following stabilization of disease). The complication rate in these 2 groups were 31.8% and 3.3% (P<0.025), mortality 13.6% and 0% and choledochus exploratory rate 90.9% and 56.7%, respectively. ConclusionsThe results suggest that earlier operation should be performed when obstruction of bile duct is dominant, SGP is exacerbated or SGP is complicated with diffuse peritonitis. In general, non-operation systematic therapy may be preferably considered , then delayed operation after clinical symptoms controlled for 6～8 wks can reduce the mortality of SGP.