Surgical management for chronic pancreatitis

This study reviewed the results of surgery for chronic pancreatitis. We als o attempted to identify any factors that may influence outcome. A 10-year r etrospective chart review was carried out on all patients undergoing surger y for the diagnosis of chronic pancreatitis. Twenty-three patients were ide ntified. Alcohol was the most common etiology, but other causes were identi fied. All but two patients had abnormal ductal anatomy on endoscopic retrog rade cholangiopancreatography. A total of 23 patients underwent six differe nt operations. There were five complications and no perioperative deaths. O nly one patient had to be readmitted for pancreatitis during follow-up. The majority of patients reported some improvement with their pain. Patients w ho continued to use alcohol had the worst results in regard to weight gain and pain control. The results of our study are consistent with the current literature in regard to morbidity and mortality. Surgical treatment had min imal effect on endocrine and exocrine function. Weight loss was avoided in the majority of patients. Addition of biliary bypass to the Puestow procedu re did not increase morbidity. Poorest results were obtained in patients wh o continued to use alcohol. A basic algorithm for management of this diseas e process is given.