IS THERE STILL A ROLE FOR DISTAL PANCREATECTOMY IN SURGERY FOR CHRONIC-PANCREATITIS

The medical records of patients subjected to distal pancreatectomy for chronic pancreatitis from 1982 to 1992 were reviewed to ascertain if pain relief could be predicted based on computed axial tomography (CAT ) and endoscopic retrograde cholangiopancreatography (ERCP) findings. Of 10 patients who had severe pain preoperatively and disease limited to the body or tail of the pancreas, 9 had no pain or only mild pain p ostoperatively. Of 7 patients with severe pain preoperatively and diff use disease or disease localized to the head of the pancreas, 6 requir ed further hospitalization and resection or drainage procedures for se vere, recurrent pain. We believe 50% to 60% of distal pancreatectomy p rocedures meet most criteria for the best operation for a select group of patients with chronic pancreatitis: those patients with severe pai n, small ducts (<5 mm), and whose disease is limited to the body or ta il of the gland.