Surgery for Chronic Pancreatitis

Abstract

A retrospective study of 49 patients with chronic obstructive and chronic calcific pancreatitis is presented. All patients were operated upon and underwent either a partial pancreatectomy or internal drainage of the ductal system into a Roux-en-Y loop of jejunum. The criteria for selection of operation are discussed, and the follow-up of the two operative groups is given. In patients selected as described, internal drainage provided better relief of pain and was accomplished with a lower operative mortality and morbidity and with less postoperative pancreatic insufficiency.

Outcome After Lateral Pancreaticojejunostomy for Chronic Pancreatitis

“…Mortality rates in the range of 0% to 5% have been reported in several recent studies. [5][6][7][8] In 53 patients (62%), LPJ was combined with another procedure to manage a complication of chronic pancreatitis. Twenty-six patients (31%) had associated pseudocysts.…”

“…Several studies have noted that abstinence is associated with a better outcome after LPJ. '8"19 Continued narcotic use clearly increased as the health status deteriorated (good: 2 [13%]; fair, 6 [31 %]; poor, 14 [50%]). The obvious implication of this finding was that fair or poor health related to continuation ofpain requiring analgesia; however, this was not always the case.…”

First Experiences with Duodenum-Preserving Resection of the Head of the Pancreas in the Treatment of Chronic Pancreatitis

“…For many years the standard surgical therapy of this entity was Whipple's procedure. This operation was origi nally introduced for the treatment of malignant tumors [7,8], However, in a benign disease like chronic pancreatitis, duodenectomy with resection of the common bile duct and stomach is an unnecessary risk, because this extended procedure is associated with a high morbidity and mortal ity rate [9][10][11][12][13][14][15], With the development of the pylorus-pre serving modification of Whipple's operation, these disap pointing results could be improved [9], Since the duode num plays an important role in the regulation of the diges tive process and gastrointestinal hormone release [16][17][18], the ideal is to preserve the whole duodenum. To achieve this, Beger et al [4] developed the technique of duode num-preserving resection of the head of the pancreas.…”

Post-Operative Outcome in Patients Who Have Undergone Lateral Pancreaticojejunostomy for Chronic Pancreatitis

“…Mortality rates in the range of 0% to 5% have been reported in several studies. (4,5,6,10,12) Pain relief Immediately post-surgery, complete pain relief was seen in 100% patients. This was also seen in study by Adams D B et al (4) Overall, pain relief was comparable with Sato's (21) study.…”