Holden J L, Berne T V, Rosoff L
Arch Surg. 1976 Aug;111(8):858-61. doi: 10.1001/archsurg.1976.01360260026005.
Pancreatic abscess is probably the most serious complication of acute pancreatitis. During the ten-year period from 1966 to 1975, twenty-eight patients with pancreatic abscess following acute pancreatitis were treated by surgical drainage. A review of these cases revealed that there was a lull in the clinical course of the antecedent pancreatitis prior to the time of surgical drainage in 70% of the cases. Despite an aggressive surgical approach, there were major postoperative problems in 26 patients. Sepsis persisted in 14 patients. Major gastrointestinal hemorrhage occurred in seven, intra-abdominal bleeding in nine, and fistulization in 13. Fourteen patients died (a mortality of 50%). The operative treatment of pancreatic abscess must be aggressive and persistent. In addition to extensive drainage with soft sump drains, vigilance must be exercised to avoid pressure against bowel or major vessels. Reoperation should be considered if postoperative improvement is not sustained.
胰腺脓肿可能是急性胰腺炎最严重的并发症。在1966年至1975年的十年间，28例急性胰腺炎后并发胰腺脓肿的患者接受了外科引流治疗。对这些病例的回顾显示，70%的病例在外科引流前，前期胰腺炎的临床病程有一段缓解期。尽管采取了积极的手术方法，但26例患者术后仍出现了严重问题。14例患者败血症持续存在。7例发生严重胃肠道出血，9例腹腔内出血，13例发生瘘管形成。14例患者死亡（死亡率为50%）。胰腺脓肿的手术治疗必须积极且持续。除了用软引流管进行广泛引流外，还必须警惕避免压迫肠道或大血管。如果术后病情没有持续改善，应考虑再次手术。
