title: [Surgical treatment of chronic pancreatitis, 2010].
abstract: BACKGROUND
  Chronic pancreatitis (CP) is a benign inflammatory process, which can cause enlargement of the pancreatic head accompanied by severe pain and weight loss, and often leads to a significant reduction in quality of life (QoL). Basically, the disease is characterised by pain and functional disorders which are initially treated with conservative therapy, but in case of complications (uncontrollable pain or obstruction) surgical treatment is required.
  
  
  METHODS
  This article reviews the relevant literature of CP treatment, in particular randomized controlled trials and meta-analyses were involved with a comparison of different surgical treatment options for the management of CP complications.
  
  
  RESULTS
  Recent studies have demonstrated that surgical procedures are superior to endoscopic therapy as regards long-term results of QoL and pain control. There was no significant difference found in postoperative pain relief and overall mortality when duodenum-preserving pancreatic head resection (DPPHR) of Beger and its modification (duodenum and organ-preserving pancreatic head resection [DOPPHR]) were compared with pancreatoduodenectomy (PD), but hospital stay, weight gain, exocrine and endocrine insufficiency, and QoL were significantly better in the DPPHR and DOPPHR groups.
  
  
  CONCLUSIONS
  DPPHR and PD seem to be equally effective in terms of postoperative pain relief and overall mortality. However, recent data suggest that DOPPHR is superior in the treatment of CP with regard to several peri- and postoperative outcome parameters and QoL. Therefore, this should be the preferable treatment option for CP complications.
authors.affiliation: Szegedi Tudományegyetem, Általános Orvostudományi Kar, Sebészeti Klinika, Szeged. fg@surg.szote.u-uzeged.hu
authors.forename: Gyula
authors.initials: G
authors.lastname: Farkas
mesh_terms: D000328:Adult; D000368:Aged; D002760:Cholangiopancreatography, Endoscopic Retrograde; D004322:Drainage; D010188:Exocrine Pancreatic Insufficiency / Q000209:etiology / Q000378:metabolism; D005260:Female; D006801:Humans; D007515:Islets of Langerhans / Q000378:metabolism; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D015201:Meta-Analysis as Topic; D008875:Middle Aged; D010146:Pain / Q000209:etiology; D010147:Pain Measurement; D010149:Postoperative Pain / Q000209:etiology; D010180:Pancreatectomy / Q000009:adverse effects / Q000379:methods / Q000401:mortality; D016577:Pancreaticoduodenectomy / Q000009:adverse effects / Q000379:methods / Q000401:mortality; D050500:Pancreatitis, Chronic / Q000150:complications / Q000209:etiology / Q000378:metabolism / Q000401:mortality / Q000601:surgery*; D011788:Quality of Life; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome; D015430:Weight Gain