DUODENUM-PRESERVING RESECTION OF THE HEAD OF THE PANCREAS-MODIFIED PROCEDURES AND LONG-TERM RESULTS

Background/Aims: Relief of chronic pancreatitis can be accomplished su rgically or with medication. Surgical treatment of pancreatitis should preserve the endocrine and exocrine function of the pancreas. This pa per details the results of our modified procedure for resecting the he ad of the pancreas. The advantage of this procedure is small resection , preservation of endocrine and exocrine function, complete relief of pain by the pancreatic duct drainage and maintenance of function of th e duodenum and bile duct. Patients and Methods: Duodenum-preserving re section of the pancreatic head with denervation of the body and tail o f the pancreas was performed in 41 patients with severe chronic pancre atitis. Results: Mortality after a median follow-rep period of 36 mont hs was 2.4%. Complete relief or alleviation. of pain were found in 92% of patients and any other patients of recurrent pain due to postopera tive pancreatitis was not found. Eighty-seven percent of patients had maintained more than preoperative body weight. Postoperative glucose t olerance was unchanged in 88% of patients, After long-term follow-up p ostoperative exocrine function had been maintained at preoperative con dition. Conclusions: Our procedure can maintain endocrine and exocrine function of the pancreas, relieve pain well and prevent pain due to r ecurrent pancreatitis.