[Pancreaticojejunostomy in the treatment of chronic pancreatitis].
BACKGROUND
The aim of this retrospective study was to evaluate the immediate and long-term outcome of pancreaticojejunostomy (PJ) in the treatment of chronic pancreatitis. MATERIAL AND METHODS. - From 1980 to 1997, 140 patients with chronic pancreatitis with dilated Wirsung duct were treated by PJ and were studied retrospectively. There were 123 men and 17 women, with a mean age of 46 years (range: 18-79 years). Ongoing alcoholic addiction was present in 116 patients (83%). Chronic pain uncontrolled by major analgesics was the indication of PJ in 126 patients (90%).


RESULTS
The mortality rate was 1.4% (n = 2). The morbidity rate was 11% (n = 16). Mean hospital stay was 16 days (range: 8-25 days). The mean follow-up was 7.4 years (range: 2-15 years) in 94 patients. Functional results were good or mild in 93% of cases (n = 87). In seven patients (7%), the results were bad with persistence of chronic pain requiring major analgesics. A mean weight increase of 5.8 kg (range: 1-16 kg) was observed in 74 patients (79%). Twelve patients (13%) developed de novo diabetes mellitus. In the 43 patients with preoperative diabetes, 24 patients suffered deterioration of their status. No patient recovered from exocrine insufficiency.


CONCLUSIONS
In case of dilated Wirsung, PJ must be indicated preferentially because of its good efficiency on pain relief with low mortality and morbidity rates.
Pessaux
P
P
Service de chirurgie viscérale, CHU de Angers, 4, rue Larrey, 49033 Angers, cedex 01, France. pessauxpchuangers@yahoo.fr
Brehant
O
O
Lermite
E
E
Regenet
N
N
Farah
E
E
Arnaud
J-P
JP
D000293:Adolescent; D000328:Adult; D000368:Aged; D000437:Alcoholism / Q000150:complications; D002758:Cholangiography; D002908:Chronic Disease; D003920:Diabetes Mellitus / Q000209:etiology; D004108:Dilatation, Pathologic / Q000150:complications / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery; D005260:Female; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D010146:Pain / Q000209:etiology; D010183:Pancreatic Ducts / Q000473:pathology; D010193:Pancreaticojejunostomy / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D010195:Pancreatitis / Q000150:complications / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D018579:Patient Selection; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D015430:Weight Gain