Is there still a role for distal pancreatectomy in surgery for chronic pancreatitis?
The medical records of patients subjected to distal pancreatectomy for chronic pancreatitis from 1982 to 1992 were reviewed to ascertain if pain relief could be predicted based on computed axial tomography (CAT) and endoscopic retrograde cholangiopancreatography (ERCP) findings. Of 10 patients who had severe pain preoperatively and disease limited to the body or tail of the pancreas, 9 had no pain or only mild pain postoperatively. Of 7 patients with severe pain preoperatively and diffuse disease or disease localized to the head of the pancreas, 6 required further hospitalization and resection or drainage procedures for severe, recurrent pain. We believe 50% to 60% of distal pancreatectomy procedures meet most criteria for the best operation for a select group of patients with chronic pancreatitis: those patients with severe pain, small ducts (< 5 mm), and whose disease is limited to the body or tail of the gland.
Sawyer
R
R
Department of Surgery, University of California, Davis Medical Center, Sacramento, California 95817.
Frey
C F
CF
D002423:Cause of Death; D002760:Cholangiopancreatography, Endoscopic Retrograde; D002908:Chronic Disease; D003131:Combined Modality Therapy; D005500:Follow-Up Studies; D006635:Histamine H2 Antagonists / Q000627:therapeutic use; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D010146:Pain / Q000145:classification / Q000453:epidemiology* / Q000209:etiology*; D010147:Pain Measurement; D010180:Pancreatectomy / Q000379:methods*; D010184:Pancreatic Extracts / Q000627:therapeutic use; D016577:Pancreaticoduodenectomy; D010193:Pancreaticojejunostomy; D010195:Pancreatitis / Q000145:classification / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology / Q000601:surgery*; D011237:Predictive Value of Tests; D012008:Recurrence; D012086:Reoperation; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
D006635:Histamine H2 Antagonists; D010184:Pancreatic Extracts