[Clinical protocols for the treatment of severe acute pancreatitis].
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.
Liu
X
X
Department of Surgery, First Affiliated Hospital, West China University of Medical Sciences, Chengdu 610041.
Zhang
Z
Z
Yan
L
L
Jiang
J
J
Yuan
C
C
Jin
L
L
Huang
Z
Z
Hu
W
W
Chen
G
G
Li
Q
Q
Zhang
G
G
Tian
B
B
Wu
H
H
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003131:Combined Modality Therapy; D003422:Critical Care; D004359:Drug Therapy, Combination; D004365:Drugs, Chinese Herbal / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019283:Pancreatitis, Acute Necrotizing / Q000188:drug therapy* / Q000401:mortality / Q000601:surgery*; D008517:Phytotherapy; D013997:Time Factors
D004365:Drugs, Chinese Herbal