PANCREATIC SURGERY

Attempts to treat acute pancreatitis with protease inhibitors and secr etion inhibitors have been unsuccessful. Endoscopic therapy for acute pancreatitis is beneficial because it reduces the incidence of biliary sepsis. Pancreas divisum may be treated successfully by endoscopic pl acement of a dorsal duct stent. Asymptomatic pseudocysts can be safely observed rather than drained even if they persist for more than 6 wee ks. Extended pancreatic resections may improve the survival rate for p atients with locally invasive cancer. Pylorus-preserving resection may be less appropriate than the standard Whipple's resection for pancrea tic head carcinomas. Endoscopic ultrasonography may be useful in local izing islet cell tumors. Combined pancreas and kidney transplantation is associated with a better outcome than is isolated pancreas allotran splantation in diabetic patients.