Nazarenko P M, Nikulin V V, Ponomarenko A A
Department of Surgical Diseases No2, State Medical Institute, Kursk.
Khirurgiia (Mosk). 1997(9):23-5.
The analysis of surgical treatment of 126 patients with acute biliary pancreatitis is made. The authors follow an active surgical policy in patients with justified risk of surgery. The operation is carried out in two stages: 1st-radical elimination of pathologic changes of extrahepatic bile ducts, restoration of the passage through the large duodenal papilla (LDP), and 2nd stage is the operation on the pancreas. The indications and contraindications for transduodenal intervention in acute biliary pancreatitis have been determined. The authors think it necessary in destructive forms of acute pancreatitis accompanied by extensive fermentative damage of parapancreatic and retroperitoneal cellular tissue to remove it thoroughly and to drain it widely. The reoperation should be performed not earlier that 12-21 days after the initial operation. Postoperative lethality was 8.7%.
对126例急性胆源性胰腺炎患者的外科治疗进行了分析。作者对具有合理手术风险的患者采取积极的手术策略。手术分两个阶段进行：第一阶段——彻底消除肝外胆管的病理变化，恢复通过十二指肠大乳头（LDP）的通道；第二阶段是对胰腺进行手术。确定了急性胆源性胰腺炎经十二指肠干预的适应证和禁忌证。作者认为，在急性胰腺炎的坏死性形式伴有胰腺旁和腹膜后细胞组织广泛发酵性损伤的情况下，有必要彻底清除并广泛引流。再次手术应在初次手术后12至21天之后进行。术后死亡率为8.7%。
