Outcome of severe acute pancreatitis

被引:109
作者
Malangoni, MA [1 ]
Martin, AS [1 ]
机构
[1] Case Western Reserve Univ, Sch Med, Dept Surg, Metrohlth Med Ctr, Cleveland, OH 44109 USA
关键词
pancreatic necrosis; severe acute pancreatitis; surgical outcomes;
D O I
10.1016/j.amjsurg.2004.11.013
中图分类号
R61 [外科手术学];
学科分类号
摘要
Background: The treatment of severe acute pancreatitis has been evolving from routine operative management to nonoperative care for patients without evidence of pancreatic infection. Methods: Retrospective chart review of patients with severe acute pancreatitis at a single institution during a 9-year period. Results: Sixty consecutive patients had severe pancreatitis. Forty-two had pancreatic necrosis on computed axial tomography (13 infected and 29 sterile). Patients with infected necrosis and 8 with sterile necrosis had operative debridement; the remaining patients were managed without operation (n = 39). The overall mortality was 15%. Mortality was directly related to the Acute Physiology and Chronic Health Examination II and Marshall organ failure scores (P < 0.001). Patients who died had a greater incidence of nosocomial infection. Conclusions: Patients with infected pancreatic necrosis require early operative debridement, whereas those with sterile necrosis or severe pancreatitis without necrosis can usually be managed safely without surgery. (c) 2005 Excerpta Medica Inc. All rights reserved.
引用
收藏
页码:273 / 277
页数:5
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