Mier J, Ferat E, Castellanos A, Blanco R
Hospital de Especialidades del Centro Médico Nacional, Instituto Nacional del Seguro Social, México, D.F.
Rev Gastroenterol Mex. 1993 Oct-Dec;58(4):373-7.
Acute Pancreatitis is a complex clinical problem. The mexican experience in the Acute Pancreatitis treatment was analyzed, from the papers published between 1970-1990. During the first decades of the 20th century. Acute Pancreatitis was usually diagnosed at operation or at autopsy. Because a significant proportion of those diagnosed at surgery survived, early intervention was recommended. With the introduction of laboratory test, surgical diagnosis was regarded as unnecessary. In the past 30 years in has become clear that patients with severe forms of Pancreatitis do not survive without surgery and interest in the value of surgical measures has been renewed. We reviewed the papers of the surgical treatment of Acute Pancreatitis and its complications, only articles with documented surgical treatment were selected for analysis. From 1970 through 1990, 41 articles were published by Mexican Journals, only 10, fulfill the criteria, 632 patients with operative management. Patients with gall-stone associated Pancreatitis were the most frequent, 70-72%, and alcoholic Pancreatitis the second 20%; significant hospital morbidity occurred, recurrent sepsis was frequently identified; mortality rate was 52.6%. Available data do not provide any reasonable approach, therefore, we urge to develop clinical trials, with control groups for better results.
急性胰腺炎是一个复杂的临床问题。我们分析了1970年至1990年间发表的论文中墨西哥在急性胰腺炎治疗方面的经验。在20世纪的头几十年里，急性胰腺炎通常在手术时或尸检时被诊断出来。由于相当一部分在手术中被诊断出的患者存活了下来，因此建议进行早期干预。随着实验室检查的引入，手术诊断被认为没有必要。在过去30年里，很明显，重症胰腺炎患者如果不进行手术就无法存活，人们对手术措施的价值重新产生了兴趣。我们回顾了急性胰腺炎及其并发症外科治疗的相关论文，仅选择有记录的外科治疗文章进行分析。从1970年到1990年，墨西哥期刊发表了41篇文章，只有10篇符合标准，涉及632例接受手术治疗的患者。胆石相关性胰腺炎患者最为常见，占70 - 72%，酒精性胰腺炎占第二，为20%；出现了显著的医院发病率，经常发现反复发生的败血症；死亡率为52.6%。现有数据没有提供任何合理的方法，因此，我们敦促开展临床试验，并设立对照组以获得更好的结果。
