COMPLICATION FROM ADJACENT ORGANS IN CHRO NIC-PANCREATITIS MANAGEMENTBY DUODENUM-PRESERVING RESECTION OF THE HEAD OF THE PANCREAS

Chronic pancreatitis frequently generates complications through involv ement of adjacent organs. Distal common bile duct stenosis or segmenta l duodenal stenosis, the most frequent complications, are usually trea ted by resective or by-passing procedures. This study presents the exp erience with an organ and functionality sparing procedure in the treat ment of chronic pancreatitis with predominant involvement of the pancr eatic head and coexisting organ complications. Sixty-eight patients wi th severe chronic pancreatitis underwent duodenum preserving resection of the head of the pancreas. Fourty-one of these patients presented w ith organ complications: fourty with distal common bile duct stenosis, eight with duodenal stenosis, thirteen with segmental portal hyperten sion, and one patient suffered from a pancreatico-pleural fistula. All patients were prospectively documented. Mean follow-up was 4.1 years. 93% of the organ complications were permanently eradicated. Three pat ients (7%) exhibited transitory cholestasis. 88% of the patients repor ted complete relief of all symptoms. Duodenum preserving resection of the head of the pancreas is effective to treat severe chronic pancreat itis with predominant involvement of the pancreatic head. It also prov ides definitive management of associated organ complications.