[Surgical treatment of pancreatic enzyme serous effusions].
Enzymatic seritis is a rare complication of chronic pancreatitis. Thirty-four cases are analyzed from a series of 200 cases of operated chronic pancreatitis: 22 pleural effusions, 5 ascites and 7 combined effusions. The pancreatic leak was demonstrated preoperatively in 40% of cases. The leak originated from erosion of a pancreatic duct in 7 cases and leaking pseudocyst in 27 cases. All patients were operated: internal drainage (22 cases), left splenopancreatectomy (7 cases) and external drainage (5 cases). Postoperative mortality was 9% (n = 3); postoperative morbidity was 15% (n = 5). The effusion did not recur in any of the survivors, but repeat surgery for chronic pancreatitis complications was necessary in 7 patients (20.5%).


CONCLUSIONS
after failure of medical treatment, the treatment of large serous effusions is surgical: internal drainage or pancreatic resection when the lesion is located in the tail of the pancreas.
Tuech
J J
JJ
Département de Chirurgie Viscérale, CHU Angers, Angers.
Pessaux
P
P
Duplessis
R
R
Villapadierna
F
F
Cervi
C
C
Arnaud
J P
JP
D000328:Adult; D000368:Aged; D002908:Chronic Disease; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010183:Pancreatic Ducts / Q000473:pathology / Q000601:surgery; D010195:Pancreatitis / Q000150:complications*; D010996:Pleural Effusion / Q000150:complications / Q000601:surgery*; D012086:Reoperation; D012189:Retrospective Studies; D013514:Surgical Procedures, Operative / Q000379:methods*; D016896:Treatment Outcome
Le traitement chirurgical des épanchements séreux enzymatiques d'origine pancréatique.