Duodenum-preserving resection of the head of the pancreas--modified procedures and long-term results-.
OBJECTIVE
Relief of chronic pancreatitis can be accomplished surgically or with medication. Surgical treatment of pancreatitis should preserve the endocrine and exocrine function of the pancreas. This paper details the results of our modified procedure for resecting the head of the pancreas. The advantage of this procedure is small resection, preservation of endocrine and exocrine function, complete relief of pain by the pancreatic duct drainage and maintenance of function of the duodenum and bile duct.


METHODS
Duodenum-preserving resection of the pancreatic head with denervation of the body and tail of the pancreas was performed in 41 patients with severe chronic pancreatitis.


RESULTS
Mortality after a median follow-up period of 36 months was 2.4%. Complete relief or alleviation of pain were found in 92% of patients and any other patients of recurrent pain due to postoperative pancreatitis was not found. Eighty-seven percent of patients had maintained more than preoperative body weight. Postoperative glucose tolerance was unchanged in 88% of patients. After long-term follow-up postoperative exocrine function had been maintained at preoperative condition.


CONCLUSIONS
Our procedure can maintain endocrine and exocrine function of the pancreas, relieve pain well and prevent pain due to recurrent pancreatitis.
Ikenaga
H
H
Second Department of Surgery, Hokkaido University School of Medicine, Sapporo, Japan.
Katoh
H
H
Motohara
T
T
Okushiba
S
S
Shimozawa
E
E
Kanaya
S
S
Takahashi
T
T
D000328:Adult; D000368:Aged; D002908:Chronic Disease; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010180:Pancreatectomy / Q000379:methods*; D010195:Pancreatitis / Q000378:metabolism / Q000601:surgery*; D012189:Retrospective Studies