[Remote results of surgical treatment in chronic pancreatitis. Study of a series of 107 patients].
The aim of the present study was to report the follow-up results of 107 consecutive patients (among whom there were 105 males and 90 p. 100 chronic alcoholics) who have been operated from 1963 to 1976, for chronic calcifying pancreatitis. Pancreatic resection was performed in 66 patients and one or several palliative procedures in 41 patients. There was one post-operative death, after pancreatico-duodenectomy; 13 patients were lost to follow-up, 43 were dead and 50 were reviewed with a 5- to 18-year (mean: 10 years) follow-up. Secondary deaths mainly occurred during the five years following pancreatic resection. For a mean follow-up of ten years, the mortality rate was 49 p. 100 for patients who underwent pancreatic resections and 41 p. 100 for those who underwent palliative procedures. Besides pancreatitis, other complications of chronic alcohol consumption associated with smoking-related diseases were the main causes of death (carcinoma of upper respiratory tract in 6 of the 27 cases for whom the cause of death was known). Clinical results were judged as excellent or good in 70 p. 100 of the 30 patients followed after pancreatic resection, and in 65 p. 100 of the 20 patients followed after palliative surgery. Persistent alcoholism (50 p. 100 of dead patients, 10 p. 100 in living patients) appeared as a decisive factor, influencing long-term survival and determining surgical indications. In conclusion, the present study shows that: (a) in patients with chronic calcifying pancreatitis who have not stopped alcohol consumption, surgery seems indicated only in the event of complications; the surgical procedure should be limited to palliative treatment of the complication, without pancreatic resection; (b) in patients who have freed themselves from alcoholism, surgery is indicated in the event of persistent pain or complications; the choice between a partial pancreatic resection and a palliative procedure should be based on clinical symptoms and operative findings.
D000328:Adult; D000368:Aged; D000437:Alcoholism / Q000150:complications; D002908:Chronic Disease; D004386:Duodenum / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010180:Pancreatectomy / Q000009:adverse effects; D010195:Pancreatitis / Q000150:complications / Q000601:surgery*
Les résultats lointains du traitement chirurgical dans les pancréatites chroniques. Etude d'une série de 107 malades.