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目的为提高重症胆源性胰腺炎(SGP)的治疗效果，探讨SGP早期手术适应证和最佳手术时间。方法采用统计学方法回顾性分析52例SGP的手术时机与并发症及死亡情况。结果早期手术(住院48 h内)22例和延期手术(病情稳定6～8周后)30例的并发症的发生率分别为31.8%和3.3%(P<0.025)，病死率分别为13.6%和0(P<0.05)；胆总管探查率分别为90.9%和56.7%(P<0.01)。结论SGP的手术时机应采用延期与个体化相结合的处理原则，即首先应积极系统的非手术治疗，在临床症状控制6～8周后延期手术，能够降低SGP的病死率、并发症和胆总管探查率。在出现以胆道梗阻为主，胰腺炎进行加重或有重症急性胆管炎表现或并发弥漫性腹膜炎时应早期手术治疗为宜。“,”ObjectiveTo explore the early surgical indication and optimal operation timing in patients with severe gallstone pancreatitis (SGP) for the purpose of improving its therapeutic effects. Methods A retrospective analysis on optimal operation timing , complications and mortality of 52 SGP patients admitted from Jan.,1995 to May 2000 was done by statistical methods.. Results Twenty-two cases were operated at early stage (within 48 hr after admission); 30 cases at delayed stage (6～8 weeks following stabilization of disease). The complication rate in these 2 groups were 31.8% and 3.3% (P<0.025), mortality 13.6% and 0% and choledochus exploratory rate 90.9% and 56.7%, respectively. ConclusionsThe results suggest that earlier operation should be performed when obstruction of bile duct is dominant, SGP is exacerbated or SGP is complicated with diffuse peritonitis. In general, non-operation systematic therapy may be preferably considered , then delayed operation after clinical symptoms controlled for 6～8 wks can reduce the mortality of SGP.