[Surgical management of chronic pancreatitis].
Surgical indications for chronic pancreatitis can be schematically separated into five main groups: pain, effects of fibrosis on adjacent organs, the consequences of main pancreatic duct rupture above an obstruction, and suspected cancer. Finally surgery is also indicated in patients who cannot undergo endoscopic procedures (no accessible papilla) or who have too recently undergone this procedure. Surgical procedures include derivation (pancreatic, cystic, biliary) or mixed procedures combining derivation/resection or pancreatic resection. Finally splanchnicectomy can be discussed. Whatever the indication, surgical treatment must meet several goals: the approach to surgery must be multidisciplinary, surgery must be associated with low morbidity and mortality, preserve as much endocrine function as possible, improve quality of life, and be evaluated in the long term, as well as prospectively if possible. We clarify some important points about the management of patients with chronic pancreatitis before discussing the various treatments in detail.
Regimbeau
Jean-Marc
JM
Service de chirurgie viscérale et digestive, Centre Hospitalier et Universitaire, Université de Picardie Amiens Nord, Amiens. regimbeau.jean-marc@chu-amiens.fr
Dumont
Frédéric
F
Yzet
Thierry
T
Chatelain
Denis
D
Bartoli
Eacute Ric
ER
Brazier
Franck
F
Bréhant
Olivier
O
Dupas
Jean-Louis
JL
Mauvais
François
F
Delcenserie
Richard
R
D013505:Digestive System Surgical Procedures / Q000379:methods; D006801:Humans; D010180:Pancreatectomy / Q000379:methods; D050500:Pancreatitis, Chronic / Q000150:complications / Q000175:diagnosis / Q000601:surgery*