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急性出血性 膵炎에 對한 外科的考察

Surgical Observation on Acute Hemorrhagic Pancreatitis.

중앙의학 1969년 16권 3호 p.233 ~ 239
김례흠,
소속 상세정보
김례흠 (  ) - 서울대학교 의과대학 외과학교실

Abstract


A total of 24 patients with acute hemorrhagic pancreatitis admitted to the Dept. of surgery, Seoul National University Hospital during the past. 5 years (1957-1968) was studied.
Thirteen patients of the whole group were 8 less severe cases diagnosed clinically and 5 severe cases of whide early diagnosis were definity made: they were treated conservatively.
The remaining 11 patients were severe case confissred by laparotosnies under the preoperative diagnosis of generalized Peritonitis due to such as gastric and duodenal ulcer perforatin (5 case), appendicitic or intestinal perforation (4cases) and Suspecteted. Pancreatitis (2cases): they were all treated with conservative (suppuritive) measure postoperatively herider the given operative Procedures Non of mortality or serious complication was noted both in the laparotomid and in the consrvratively treated group.
The opertive procedures comprised the drainage of the lesser sac and peritoneal cavity or the diversionasy operation on the biliahy tract.
The conservative (Supportive) measure were under following categories (1) blood volume replacement, including whole blood (1-3units), plasma, fluid and electrolyter (2) control of pain with Demerol or Atropine (3) continuous suction (4) Vagolytic drugs (Atropine. Banthine, Diamox) (5) Use of steroids (6) Oxygen therapy.
From the result abtained it would appear that the prognosis of acute pancreatitis depend on rather the serverity of the disease and the prodisposed, resistance of the patient than the type of treatment.
The Authors thus came to a conclusion that even in the severe case of tie disease, when its diagosis in questionable the early laparotomy should not be hesitated so long as the case is not an extremery severe one, the linited maniplation of the viscera during operation is applied and active conservative treatment is added postoperatively.

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