title: Pancreatoduodenectomy in the management of chronic pancreatitis.
abstract: The records of 73 consecutive patients who underwent pancreatoduodenectomy for chronic pancreatitis between 1960 and 1985 were reviewed. The median size of the pancreatic duct was 5 mm. Two operative deaths (2.7%) occurred early in the series. Eighty-eight percent, 86%, and 79% of the patients had improvement in pain at six months, two years, and five years, respectively. Diabetes was present preoperatively in 25% of patients and postoperatively in 37%, 45%, and 69% of patients at six months, two years, and five years, respectively. Pancreatic enzyme preparations were used preoperatively by 26% of patients; this use increased to 75% by five years. Only four of 17 late deaths could be related to diabetes or malnutrition. In most patients, pancreatoduodenectomy achieves long-term pain improvement and permits return to normal activities. Selection of patients is important to decrease the late morbidity and mortality.
mesh_terms: D000328:Adult; D000368:Aged; D002114:Calcinosis / Q000601:surgery; D003920:Diabetes Mellitus / Q000209:etiology; D004386:Duodenum / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009294:Narcotics / Q000627:therapeutic use; D010146:Pain / Q000188:drug therapy; D010180:Pancreatectomy / Q000009:adverse effects / Q000379:methods*; D010183:Pancreatic Ducts / Q000601:surgery; D010192:Pancreatic Pseudocyst / Q000601:surgery; D010195:Pancreatitis / Q000000981:diagnostic imaging / Q000601:surgery*; D011788:Quality of Life; D011859:Radiography; D012086:Reoperation
chemical_list: D009294:Narcotics