Size of the pancreatic head as a prognostic factor for the outcome of Beger's procedure for painful chronic pancreatitis.
BACKGROUND
Duodenum-preserving resection of the head of the pancreas (DPRHP) according to Beger has been developed as an alternative to pylorus-preserving resection of the pancreatic head for painful chronic pancreatitis.


METHODS
Between 1988 and 2000, 36 consecutive DPRHPs were performed. The group was divided into patients with (group 1; n = 23) and without (group 2; n = 13) significant enlargement of the pancreatic head. Pain was the indication for surgery in all patients.


RESULTS
Complications occurred in 12 patients, necessitating reoperation in 11. Initial overall results were favourable; significant improvement or complete relief of pain was reported in 27 of 35 patients. Long-term results were obtained in 27 of 30 patients; the overall success rate was 16 of 27, 13 of 16 patients with distinct enlargement of the pancreatic head and 3 of the 11 with minimal or no enlargement (P = 0.018).


CONCLUSIONS
DPRHP can be performed with good early results. This effect is sustained in patients with distinct localized disease of the pancreatic head. In those without, the long-term results are disappointing.
Keus
E
E
Department of Surgery, St Elisabeth Hospital, Tilburg, The Netherlands.
van Laarhoven
C J H M
CJ
Eddes
E H
EH
Masclee
A A M
AA
Schipper
M E I
ME
Gooszen
H G
HG
D000328:Adult; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000379:methods; D002908:Chronic Disease; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010148:Intractable Pain / Q000209:etiology / Q000601:surgery; D010179:Pancreas / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D010195:Pancreatitis / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D011379:Prognosis; D017741:Survivors; D014057:Tomography, X-Ray Computed / Q000379:methods