Grana W, Wise L
Am Surg. 1976 Feb;42(2):128-34.
Two hundred and thirty-seven cases of acute pancreatitis were reviewed and the etiology and prognostic features were analyzed. The following were found to adversely affect prognosis: female sex, old age and low blood pressure, jaundice or disorientation on admission. The results also indicate that if a patient survives the first attack of acute pancreatitis, he is unlikely to have an overwhelming fatal attack later on. One hundred and ninety-four patients were treated conservatively, with a mortality rate of 8.8 per cent and morbidity rate of 20 per cent. Thirteen patients were semi-electively operated on for biliary tract disease with no mortality. The remaining 30 patients underwent emergency laparotomy. The mortality in this latter group was 23 per cent and the morbidity rate was 77 per cent. These results suggest that emergency laparotomy should only be advised for specific indications. In addition, our data suggest that if laparotomy is performed for acute pancreatitis, the peripancreatic area should not be drained unless an abscess or pancreatic necrosis is present.
回顾了237例急性胰腺炎病例，并分析了其病因和预后特征。发现以下因素对预后有不利影响：女性、老年、入院时低血压、黄疸或意识障碍。结果还表明，如果患者在急性胰腺炎首次发作后存活下来，以后不太可能发生致命的严重发作。194例患者接受了保守治疗，死亡率为8.8%，发病率为20%。13例患者因胆道疾病接受了半选择性手术，无死亡病例。其余30例患者接受了急诊剖腹手术。后一组的死亡率为23%，发病率为77%。这些结果表明，急诊剖腹手术仅应在特定指征下进行。此外，我们的数据表明，如果因急性胰腺炎进行剖腹手术，除非存在脓肿或胰腺坏死，否则不应引流胰周区域。
