LONG-TERM RESULTS OF THE SURGICAL-MANAGEMENT OF CHRONIC-PANCREATITIS

To investigate the long-term results of surgical management of chronic pancreatitis, we reviewed the hospital records of 50 consecutive pati ents who underwent surgery for chronic pancreatitis between 1975 and 1 985. The principal indications for surgery were abdominal pain (100%), pseudocyst (24%), and biliary obstruction (42%). Surgeries included p ancreatic duct drainage (56%), distal pancreatic resection (20%), and drainage of a pancreatic pseudocyst (24%). Follow-up averaged 5.2 year s (range 5 to 11 years). Reoperation was required in 31 patients durin g the extended follow-up period. Principal indications for reoperation were abdominal pain (93%), recurrent pancreatic pseudocyst (32%), and uncertainty of the diagnosis of chronic pancreatitis (26%). Subsequen t operations included cholecystectomy (35%), pseudocyst drainage (32%) , splanchnicectomy (16%), and pancreatic biopsy (16%); and eliminated abdominal pain in 24 patients (83%). The diagnosis of chronic pancreat itis was not revised in any case. At most recent follow-up, 30 patient s (60%) were well and without abdominal pain, 12 (24%) experienced int ermittent abdominal pain, and one (2%) had continued abdominal pain th at required narcotics. Five patients (10%) died of other causes, and t wo (4%) were lost to follow-up. We conclude that pain, the principal s ymptom of chronic pancreatitis, can be eliminated or reduced in the ma jority of patients by appropriate surgical therapy.