Rl. Byrne et al., SURGERY FOR CHRONIC-PANCREATITIS - A REVIEW OF 12 YEARS EXPERIENCE, Annals of the Royal College of Surgeons of England, 79(6), 1997, pp. 405-409
The surgical management of chronic pancreatitis remains controversial.
We have practised a selective approach to surgery using symptoms and
endoscopic retrograde cholangiopancreatography (ERCP) as the indicatio
ns for operation and the procedure performed. A total of 76 patients w
ho underwent surgery for chronic pancreatitis over a 12 year period we
re reviewed. Of the patients, 24 (32%) had a Whipple's resection (WR),
41 (54%) distal pancreatectomy (DP) with drainage, and 11 (14%) had o
ther procedures. Eleven patients had died. Hospital records were revie
wed and of the 65 patients alive at follow-up, 51 (79%) were interview
ed. Twenty-three patients (74%) who underwent DP reported either excel
lent or good general health compared with 7 (44%) who had WR (P= 0.04)
. However, there was no difference in general health between operative
groups using visual analogue scales. There was no difference in pain
at follow-up between DP and WR. Of patients interviewed, 88% felt that
their pain was better than before operation and 25 (49%) had no pain
at all. Diabetes developed more frequently after DP (P=0.005) than aft
er WR. Good results can be achieved by pancreatic resection when caref
ul selection is exercised.