From July 1994 to October 1995, a prospective study was conducted at the First Department of Surgery, Mie University School of Medicine, to assess the usefulness of a prognosis score based on the Japanese criteria for the severity of acute pancreatitis. Ten patients with severe acute pancreatitis were treated, and all had good outcomes there were no deaths. In selecting early treatment according to the scoring of severity, we suggest that when the prognosis score is 2 or more and the APACHE II score is 8 or more, gallstone pancreatitis should first be treated by biliary drainage, and non-gallstone pancreatitis by peritoneal lavage. When infected pancreatic necrosis is exhibited, surgery is indicated. Conservative therapy should be selected when the prognosis score is less than 2 and the APACHE II score is less than 8. We found that the prognosis score was useful for both determining the severity of acute pancreatitis and in selecting appropriate treatment.
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