Surgical and interventional treatment of chronic pancreatitis

The management of patients with chronic pancreatitis (CP) remains a challenging problem. Main indications for surgery are intractable pain, suspicion of malignancy, and involvement of adjacent organs. The main goal of surgical treatment is improvement of patient quality of life. The surgical treatme...

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Bibliographic Details
Published in:Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.] 2004-01, Vol.4 (6), p.540-550
Main Authors: Cunha, J.E.M., Penteado, S., Jukemura, J., Machado, M.C.C., Bacchella, T.
Format: Article
Language:English
Subjects:
Chronic Disease
Chronic pancreatitis
Drainage
Endoscopy
Humans
Nerve Block
Neural block
Pain - prevention & control
Pancreatic Ducts - surgery
Pancreatitis - physiopathology
Pancreatitis - surgery
Pancreatitis - therapy
Postoperative Complications - prevention & control
Quality of life
Review
Surgery, complications
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Summary:The management of patients with chronic pancreatitis (CP) remains a challenging problem. Main indications for surgery are intractable pain, suspicion of malignancy, and involvement of adjacent organs. The main goal of surgical treatment is improvement of patient quality of life. The surgical treatment approach usually involves proximal pancreatic resection, but lateral pancreatojejunal drainage may be used for large-duct disease. The newer duodenum-preserving head resections of Beger and Frey provide good pain control and preservation of pancreatic function. Thoracoscopic splanchnicectomy and the endoscopic approach await confirmatory trials to confirm their efficiency in the management of CP. Common bile duct obstruction is addressed by distal Rouxen-Y choledochojejunostomy but when combined with dudodenal obstruction must be treated by pancreatic head resection. Pancreatic ascites due to disrupted pancreatic duct should be treated by internal drainage. The approach to CP is multidisciplinary, tailoring the various therapeutic options to meet each individual patient's needs.
ISSN:1424-3903
1424-3911
DOI:10.1159/000081560