[The role of pancreatojejunostomy in the treatment of chronic pancreatitis].
From 1978 to 1995, 120 patients (105 males, 15 females, mean age: 46 years) underwent pancreatico jejunostomy (PJ) for chronic pancreatitis (CP). Alcohol abuse was presented in 105 cases (87.5%). PJ was the unique procedure in 67 cases; it was associated with a biliary or a duodenal diversion in respectively 38 cases and 5 cases. In ten cases, three diversions were performed. Postoperative mortality was 1.6% (n = 2), postoperative morbidity was 10% (n = 12). Mean hospital stay was 16 days. Fifteen patients (13%) required a second operation some years subsequent to the PJ, due to the progress of the CP or alcohol abuse. In the late postoperative course 22 deaths occurred (18.5%), 8 of them were directly related to alcohol abuse. Mean follow-up was 7 years. Good and medium results for pain were evaluated to 92%, but the progression of exocrine or endocrine pancreatic insufficiency indicates that wirsung decompression was insufficient to stop the progressive sclerosis. In conclusion, PJ was our preferred surgical procedure in CP treatment, when the wirsung was dilated.
Département de Chirurgie Viscérale, C.H.U.-Angers.
J P
JP
Arnaud
C
C
Cervi
J J
JJ
Tuech
D000293:Adolescent; D000328:Adult; D000368:Aged; D000437:Alcoholism / Q000150:complications; D000713:Anastomosis, Roux-en-Y; D002423:Cause of Death; D002908:Chronic Disease; D004108:Dilatation, Pathologic / Q000473:pathology / Q000601:surgery; D018450:Disease Progression; D010188:Exocrine Pancreatic Insufficiency / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010183:Pancreatic Ducts / Q000473:pathology / Q000601:surgery; D010193:Pancreaticojejunostomy / Q000009:adverse effects; D010195:Pancreatitis / Q000209:etiology / Q000601:surgery*; D019512:Pancreatitis, Alcoholic / Q000209:etiology / Q000601:surgery; D012086:Reoperation; D012189:Retrospective Studies; D012598:Sclerosis; D015996:Survival Rate; D016896:Treatment Outcome
Place de la pancréatico-jéjunostomie dans le traitement des pancréatites chroniques.