Study On The Operation Opportunity Of Severe Acute Biliary Pancreatitis

Objective: To investigate the affecting of the operation opportunity of severe acute biliary pancreatitis (SABP) about prognosis and to study the risk factor affecting the mortality of this and to reduce postoperative mortality. Methods: The clinical data of 78 patients with SABP admitted to the department of surgery of our hospital were retrospectively analyzed. The operation opportunity, the cure rate, the relapse rate, the mortality rate and the risk factoring the mortality were analyzed in 78 patients with the SABP . Results: Based on the analysis of the treatment methods and its outcome , SABP should be divided into two types according to the duct obstruction and the timing of surgical .(1) There are 12 patients of non-obstructive mild type SABP received surgical operations with in 2 weeks after the onset, 7 cases were cured, 9 cases had complications, 5 cases died; of 42 patients received surgical operations after 2 weeks from onset, 38 cases were cured, 9 cases had complications, 4 cases died; (2) There are 10 patients of obstructive mild type SABP received surgical operations with in 2 weeks after the onset, 7 cases were cured, 6 cases had complications, 3 cases died; of 14 patients received surgical operations after 2 weeks from onset, 12 cases were cured, 7 cases had complications, 2 cases died. the incidence of complications and mortality had significantly difference in different operation opportunity of non- obstructive group. Multiple factor Logistic regression analysis indicated that the MODS(OR=15.35, P<0.05), APACHEâ…¡score (OR=2.41, P<0.05) were the independent risk factor affecting the prognosis of SABP. Conclusion: The principle of individual operation is importance of SABP. The operation opportunity is one of the most important factors impact the mortality of SABP . The non-obstructive type patients should be cure of better in conservative way. Therefore, to make sure a reasonable operation opportunity and early prevention and correct management on the risk factors play critical roles in reducing the mortality of SABP.