Has the Partington procedure for chronic pancreatitis become a thing of the past? A review of the evidence.
BACKGROUND
For the surgical management of chronic pancreatitis with an inflammatory pancreatic head mass, extended drainage operations such as Beger and Frey procedures were established in the 1980s as an alternative to resectional procedures like pancreaticoduodenectomy and as opposed to simple drainage operations such as lateral pancreaticojejunostomy, that is, the Partington procedure. With the relatively rapid adoption of the two procedures, it seems that the Partington procedure has become a thing of the past.


METHODS
The Partington procedure was re-evaluated with regard to the historical aspects and its present status by a literature review.


RESULTS
The results show that this procedure relieves chronic abdominal pain in 66-91% of patients with a mean follow-up of 3.5-9.1 years. It is important to note that this procedure is generally used for inflammatory disease left of the gastroduodenal artery and is specifically not used as the procedure of choice for inflammatory disease of the pancreatic head.


CONCLUSIONS
For patients with a dilated main pancreatic duct but without an inflammatory pancreatic head mass, the Partington procedure is still the procedure of choice, since it is technically simple to perform with a minimum of morbidity and mortality, preserving pancreatic endocrine and exocrine function. Because it is a relatively simple technique, the laparoscopic approach will be justified as a treatment of appropriate patients in the near future.
Department of Hepatobiliary Pancreatic and Transplant Surgery, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu, 514-8507, Japan. isaji-s@clin.medic.mie-u.ac.jp
Shuji
S
Isaji
D006801:Humans; D010535:Laparoscopy; D010180:Pancreatectomy / Q000379:methods*; D010193:Pancreaticojejunostomy / Q000379:methods / Q000639:trends*; D050500:Pancreatitis, Chronic / Q000601:surgery*; D016896:Treatment Outcome