[The indication and mode of surgery for the treatment of patients with severe acute pancreatitis].

OBJECTIVE: To study the indication and mode of surgical management in patients with severe acute pancreatitis (SAP). METHOD: 41 patients with SAP were grouped for conservative treatment or surgical. The main procedures of surgical management were pancreatic debridement, peripancreatic and coeliac drainage, combined with peripancreatic instillation and suction alternatively. RESULT: Conservative treatment was adopted in 22 patients (16 patients in grade I, 6 in grade II), among them 19 recovered, and 3 of grade II died. 19 patients underwent surgical treatment including 7 in grade I, 12 in grade II). 15 patients were cured, 4 patients of grade II died. CONCLUSION: Timely operation is necessary for the patients with infection and complications. Surgical intervention is recommended for patients older than 60 years old. Surgery should be less traumatic, simple and prompt. Surgical or conservative treatment are chosen according to the patients' conditions. The cure rate of SAP can be improved.