Surgery of chronic pancreatitis

Abstract Chronic pancreatitis is a progressive disease of multiple etiologies. Surgery is frequently indicated for relief of debilitating pain as well as to address other complications, and three operations have proven effective. The pancreatico-duodenectomy (Whipple) procedure results in excellent...

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Bibliographic Details
Published in:The American journal of surgery 2007-10, Vol.194 (4), p.S53-S60
Main Authors: Frey, Charles F., M.D, Andersen, Dana K., M.D
Format: Article
Language:English
Subjects:
Beger procedure
Biological and medical sciences
Chronic pancreatitis
Cysts
Duodenum-preserving pancreatic head resection
Frey procedure
Gastroenterology. Liver. Pancreas. Abdomen
General aspects
Liver. Biliary tract. Portal circulation. Exocrine pancreas
Local resection of the pancreatic head with longitudinal pancreatico-jejunostomy
Medical sciences
Mortality
Other diseases. Semiology
Pain management
Pancreas
Surgery
Whipple procedure
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Summary:Abstract Chronic pancreatitis is a progressive disease of multiple etiologies. Surgery is frequently indicated for relief of debilitating pain as well as to address other complications, and three operations have proven effective. The pancreatico-duodenectomy (Whipple) procedure results in excellent long-term pain relief, but is associated with a low mortality rate and a persistent risk of early and late complications. The duodenum-preserving pancreatic head resection (DPPHR) introduced by Beger et al, and the local resection of the pancreatic head with longitudinal pancreatico-jejunostomy (LR-LPJ) devised by Frey, achieve the same high rate of pain relief long term but are associated with lower rates of perioperative complications and a decreased incidence of diabetes long term. All 3 operations address the head of the pancreas as the nidus of persistent inflammation, and all 3 achieve success with both dilated and nondilated duct disease. The LR-LPJ has a lower risk of perioperative problems and may be easier to perform.
ISSN:0002-9610
1879-1883
DOI:10.1016/j.amjsurg.2007.05.026