Retrospectives analysis of treatment strategy in severe acute pancreatitis(SAP) patients        LONG Yun*, GUO Xin-hua, LIU Da-wei, et al. *Department of Critical Care Medicine, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China
Corresponding author: LIU Da-wei, E-mail: dwliu98@yahoo.com
Abstract    Objective    To explore the optimal treatment strategy in SAP for improving patients outcome. Metheods Retrospective analysis of clinical data in 57 SAP patients from Jan. 1999 to Jan.2012 in department of critical care medicine of Peking Union Medical College Hospital. Result    26 patients did not receive any drainage therapy and operation during admission,their mortality were 11.1%（3/26），intestinal perforation in 1 patient complication morbility was 3.8%（1/26）.22 patients received at least 1 percutaneous catheter drainage(PCD) during admission,and 86.6% patients(19/22) received operation therapy before or after PCD. 77.3% patients（17/22）had a significant temperature decrement in 3 days after PCD therapy, overall mortality was 22.7%（5/22），intraabdominal bleeding happened in 1 patient,morbility was 4.5%(1/22).28 patients received operation therapy during admission, 11 patients were received cholecystectomy and common bile duct exploration T-tube choledochotomy，only 1 patient received Endoscopic Sphincterectomy），16 patients received surgical debridement of necrosis 7 patients because of continuous febrile after nonsurgical therapy or PCD, overall mortaliy were 35.7%（10/28）,and complication morbility were46.4%（13/28）. Logistic analysis indicated,septic shock and MODS were independent risk factor for SAP outcome. Conclusion    Strategy of SAP was comprehensive and combined. Common bile duct exploration should be taken in the beginning for comment bile duct obstruction patients. Comprehensive nonsurgical therapy was very important in the early stage, If febrile became continuous and organ function deteriorated, PCD and surgical intervention should be done alone or combined.