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[Clinical protocols for the treatment of severe acute pancreatitis]
1Department of Surgery, First Affiliated Hospital, West China University of Medical Sciences, Chengdu 610041.
Objective:
To set up principles for the treatment of severe acute pancreatitis (SAP).
Methods:
The therapeutic principles and results of SAP in three periods were analyzed. Period I (1980 - 1990) was characterized by early surgical intervention supplemented with integrated traditional and western medical therapy, period II (1991 - 1993) by integrated traditional and western medical therapy supplemented with surgery for early complications, and period III (1994 - 1997) by integrated traditional and western medical therapy supplemented with surgery for local infectious complications only.
Results:
Because of the improvement of intensive care, the operation rates kept declining in the three periods. They were 77.59%, 54.55% and 29.55% with a mortality rate of 40.52%, 17.17% and 11.36%, respectively.
Conclusions:
Integrated traditional and western medicine has been effective in most SAP patients, and surgery is indicated only for late complications such as necrotizing infection. Early surgery should be restricted.