244. Die endokrine Pankreasrestfunktion nach unterschiedlicher Pankreasresektion von Patienten mit chronischer Pankreatitis

Abstract

877 pain or extrapancreatic complications. A long pancreojejunostomy was combined with transduodenal papilloplasty of the duct of Wirsung. Early mortality was 5.3%; late mortality 7.9%. Fifty-nine patients were free of pain; 7 patients underwent reoperation for pain (0% mortality). At present, 61 patients are free of pain. Thirty-two are diabetic; 13 are treated with insulin. The operation did not significantly influence the endocrine status. Long-term endocrine function is stable in nondiabetics. The resuits show the feasibility of nonresection operations for chronic pancreatitis to preserve the remaining exocrine and endocrine function. Key words: Chronic pancreatitis -Transduodenal papilloplasty -Diabetes mellitus. Zusammenfassung. Residual Endocrine Pancreatic Reserve After Subtotal Pancreatectomy Due to Chronic PancreatitisSummary. In patients with chronic pancreatitis and organ complications, subtotal resection (Whipple procedure, tail resection) is indicated. Postoperative insufficiency may be influenced by the mode of surgery. To assess the reserve of the residual pancreas, a follow-up study was carried out on 20 patients -10 with a tail resection and 10 with a head resection. Normal or slightly disturbed responses were observed in the patients after head resection. The disturbance was obvious in cases with duct occlusion, but there was less alteration in patients who had undergone the modified Whipple operation. In cases of head resection, an organ-sparing surgical procedure should be favored.

Pankreaschirurgie am Knappschaftskrankenhaus Bochum-Langendreer zwischen 1975 und 1996

“…So konnte eine verbesserte endokrine Funktion bei der Pyloruserhaltung nachgewiesen werden. Zu erkla È ren ist dieses Ergebnis damit, daû durch das Belassen der Antrum-, Pylorusund Bulbuseinheit die digestionsfo È rdernden Mechanismen weitgehend erhalten bleiben [15,16]. Bei der Auswertung der Letalita Èt zeigte sich zwischen beiden Gruppen ein Unterschied, der jedoch statistisch nicht signifikant war.…”