Yan L N, Zhang Z D, Liu X B
First Affiliated Hospital, West China University of Medical Sciences, Chengdu.
Zhonghua Wai Ke Za Zhi. 1994 Apr;32(4):224-6.
The type of operation in the treatment of acute necrotizing pancreatitis (ANP) is still controversial. Seventy-two surgical cases of ANP by using three different approaches since 1985 were analyzed retrospectively. The total mortality rate was 25%. The sump drainage was used in 28 cases, marsupialization in 11 cases and retroperitoneal drainage in 33 cases. The mortality rates were 25%, 36.4% and 21% respectively. The selection of approaches should be determined by clinical pathological types and by whether or not there is a retroperitoneal invasion. Sump drainage is a simple approach for ANP and is preferable in cases of sporadic focal necrosis. For extensive fusional pancreatic necrosis not complicated with retroperitoneal invasion, marsupialization is used, and in those with the invasion retroperitoneal drainage is the procedure of choice.
急性坏死性胰腺炎（ANP）治疗中的手术方式仍存在争议。回顾性分析了自1985年以来采用三种不同方法治疗的72例ANP手术病例。总死亡率为25%。其中28例行灌洗引流，11例行袋形缝合术，33例行腹膜后引流。死亡率分别为25%、36.4%和21%。手术方式的选择应根据临床病理类型以及是否存在腹膜后侵犯来决定。灌洗引流是治疗ANP的一种简单方法，对于散在性局灶性坏死病例较为适用。对于广泛融合性胰腺坏死且无腹膜后侵犯者，采用袋形缝合术；对于有腹膜后侵犯者，腹膜后引流是首选术式。
