diff --git a/openhis-server-new/openhis-application/src/main/java/com/openhis/web/doctorstation/appservice/impl/DoctorStationAdviceAppServiceImpl.java b/openhis-server-new/openhis-application/src/main/java/com/openhis/web/doctorstation/appservice/impl/DoctorStationAdviceAppServiceImpl.java
index 69471421f..66ad09c45 100755
--- a/openhis-server-new/openhis-application/src/main/java/com/openhis/web/doctorstation/appservice/impl/DoctorStationAdviceAppServiceImpl.java
+++ b/openhis-server-new/openhis-application/src/main/java/com/openhis/web/doctorstation/appservice/impl/DoctorStationAdviceAppServiceImpl.java
@@ -967,7 +967,6 @@ public class DoctorStationAdviceAppServiceImpl implements IDoctorStationAdviceAp
             // 删除已经产生的药品发放信息
             iMedicationDispenseService.deleteMedicationDispense(adviceSaveDto.getRequestId());
             // 🔧 Bug Fix #219: 删除费用项
-            Long requestId = adviceSaveDto.getRequestId();
             String serviceTable = CommonConstants.TableName.MED_MEDICATION_REQUEST;
             // 直接删除费用项
             iChargeItemService.deleteByServiceTableAndId(serviceTable, requestId);
@@ -1743,7 +1742,6 @@ public class DoctorStationAdviceAppServiceImpl implements IDoctorStationAdviceAp
                     new LambdaQueryWrapper<ServiceRequest>().eq(ServiceRequest::getParentId,
                             requestId));// 删除诊疗套餐对应的子项
             // 🔧 Bug Fix #219: 删除费用项
-            Long requestId = adviceSaveDto.getRequestId();
             String serviceTable = CommonConstants.TableName.WOR_SERVICE_REQUEST;
             // 直接删除费用项
             iChargeItemService.deleteByServiceTableAndId(serviceTable, requestId);
@@ -1800,8 +1798,9 @@ public class DoctorStationAdviceAppServiceImpl implements IDoctorStationAdviceAp
                 log.info("handService - 自动补全founderOrgId: founderOrgId={}", adviceSaveDto.getFounderOrgId());
             }
             
-            // 🔧 Bug Fix #238: 诊疗项目执行科室非空校验
-            if (adviceSaveDto.getAdviceType() != null && adviceSaveDto.getAdviceType() == 3) {
+            // 🔧 Bug Fix #238/#454: 诊疗项目执行科室非空校验（删除操作跳过校验）
+            if (adviceSaveDto.getAdviceType() != null && adviceSaveDto.getAdviceType() == 3
+                    && !DbOpType.DELETE.getCode().equals(adviceSaveDto.getDbOpType())) {
                 Long effectiveOrgId = adviceSaveDto.getEffectiveOrgId();
                 if (effectiveOrgId == null) {
                     throw new ServiceException("诊疗项目必须选择执行科室");