Pancreaticoduodenectomy and Pancreatic Resection in Chronic Pancreatitis

Kim, Han Joon; Lee, Kwang Soo; Lee, Kyeong Geun; Kwon, Oh Jung; Lee, Heung Woo

Abstract

PURPOSE: Chronic pancreatitis is difficult to cure because relapse is common. In particular the removal of stone is very difficult in pancreatolithiasis (pancreatic stone), and is associated with pancreatic duct stenosis. We attempted to evaluate the risk and the outcome of pancreatic resection in chronic pancreatitis.
METHODS
We retrospectively reviewed the clinical records of twelve patients with chronic pancreatitis who had undergone pancreatic resection at our hospital between January, 1991 and December, 2000.
RESULTS
Pancreaticoduodenectomy was performed in nine cases and distal pancreatectomy in three cases. In the nine cases of pancreaticoduodenectomy, five cases were associated with pancreatolith and four cases were suspected malignancy. In one case of distal pancreatectomy, a pigtail drain was inserted due to postoperative pancreatic leakage. Additionally, one patient who underwent distal pancreatectomy was readmitted one year later due to recurred pancreatitis. The remaining ten patients were discharged without complications and followed up without pain.
CONCLUSION
According to two complementary theories (visceral compartment syndorme and neural inflammatory theory), pancreatic resection is better than more conservative treatment, ensuring the elimination of pain. If performed by an expert surgeon, pancreatic resection is a safe and effective treatment for chronic pancreatitis.