title: Duodenum-preserving resection of the head of the pancreas in severe chronic pancreatitis. Early and late results.
abstract: In 128 patients with severe chronic pancreatitis and inflammatory enlargement of the head of the pancreas, a duodenum-preserving resection of the pancreatic head was performed. Median post-operative hospitalization was 15.5 days, and the frequency of reoperation was 5.5%. One patient died during the early post-operative phase, and hospital mortality amounted to 0.8%. After a median follow-up period of 3.6 years (range of 7 months to 16 years), six of 127 patients died (late mortality of 4.7%). Seventy-seven per cent of the patients were completely free of abdominal pain, 67% returned to their former occupations. During the late follow-up period, the glucose metabolism was unchanged in 80.7% of the patients, in 13.7% it deteriorated, and in 5.5% it improved permanently; 80% of the patients experienced a marked increase in weight averaging 8.7 kg. Compared with the Whipple procedure, the duodenum-preserving resection of the head of the pancreas spares the patient with chronic pancreatitis a gastrectomy, duodenectomy, and resection of the extrahepatic biliary ducts. In terms of a subtotal resection, the limited operative intervention at the head of the pancreas and the preservation of the duodenum explain the low early and late postoperative morbidity and mortality.
authors.affiliation: Department of General Surgery, University of Ulm, Federal Republic of Germany.
authors.forename: H G
authors.initials: HG
authors.lastname: Beger
authors.forename: M
authors.initials: M
authors.lastname: Büchler
authors.forename: R R
authors.initials: RR
authors.lastname: Bittner
authors.forename: W
authors.initials: W
authors.lastname: Oettinger
authors.forename: R
authors.initials: R
authors.lastname: Roscher
mesh_terms: D000328:Adult; D000368:Aged; D002908:Chronic Disease; D004386:Duodenum; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007583:Jejunum / Q000601:surgery; D007902:Length of Stay; D008297:Male; D008722:Methods; D008875:Middle Aged; D010179:Pancreas / Q000601:surgery*; D010195:Pancreatitis / Q000601:surgery*; D011183:Postoperative Complications / Q000209:etiology; D012086:Reoperation; D013997:Time Factors