Long term results of lateral pancreaticojejunostomy for chronic alcoholic pancreatitis

Objective: To assess our long term results of lateral pancreaticojejunostom y in patients with alcoholic pancreatitis. Design: Retrospective study. Setting: University hospital, France. Subjects: 57 patients (48 men, 9 women, mean (SD) age 46 (7) years who requ ired surgical treatment of chronic alcoholic pancreatitis between January 1 977 and October 1995. Interventions: Lateral pancreaticojejunostomy with or without another proce dure. Outcome classified as excellent, good, fair, or poor. Main outcome measures: Postoperative morbidity and mortality: relief of pai n: reduction in use of analgesics and exocrine supplements; effect on exocr ine and endocrine insufficiency; and return to paid work. Results: There were no postoperative deaths and no pancreatic fistulae, but there were 17 other postoperative complications (30%). Median follow up wa s 65 months (range 8-206), during which 12 patients died (21%). Result was judged excellent in 16 (28%). good in 27 (47%), fair in 5 (9%), and poor in 9 (16%). Pain control was significantly improved, analgesic usage decrease d, less pancreatic enzyme supplementation was required, and 25 patients ret urned to paid work (p = 0.0001 in each case). Exocrine and endocrine functi on remained stable. The results were better if the patient gave up misusing alcohol (p = 0.03) and if the operation was done within 4 years of the dev elopment of pancreatitis (p = 0.03). Conclusions: Lateral pancreaticojejunostomy is a safe procedure that can im prove functional outcome in patients with chronic alcoholic pancreatitis, a nd does not worsen pancreatic function.