Operative management of chronic pancreatitis: A review.
BACKGROUND
Pain secondary to chronic pancreatitis is a difficult clinical problem to manage. Many patients are treated medically or undergo endoscopic therapy and surgical intervention is often reserved for those who have failed to gain adequate pain relief from a more conservative approach.


RESULTS
There have been a number of advances in the operative management of chronic pancreatitis over the last few decades and current therapies include drainage procedures (pancreaticojejunostomy, etc.), resection (pancreticoduodenectomy, etc.) and combined drainage/resection procedures (Frey procedure, etc.). Additionally, many centers currently perform total pancreatectomy with islet autotransplantation, in addition to minimally invasive options that are intended to tailor therapy to individual patients.


CONCLUSIONS
Operative management of chronic pancreatitis often improves quality of life, and is associated with low rates of morbidity and mortality. The decision as to which procedure is optimal for each patient should be based on a combination of pathologic changes, prior interventions, and individual surgeon and center experience.
Department of Surgery, Beth Israel Deaconess Medical Center, Boston, MA, USA.
John D
JD
Tillou
Department of Surgery, The University of Virginia Health System, Charlottesville, VA, USA.
Jacob A
JA
Tatum
Department of Surgery, The University of Virginia Health System, Charlottesville, VA, USA.
Joshua S
JS
Jolissaint
Division of Gastroenterology and Hepatology, University of Virginia Health System, Charlottesville, VA, USA.
Daniel S
DS
Strand
Division of Gastroenterology and Hepatology, University of Virginia Health System, Charlottesville, VA, USA.
Andrew Y
AY
Wang
Department of Surgery, The University of Virginia Health System, Charlottesville, VA, USA.
Victor
V
Zaydfudim
Department of Surgery, The University of Virginia Health System, Charlottesville, VA, USA.
Reid B
RB
Adams
Department of Surgery, The University of Virginia Health System, Charlottesville, VA, USA. Electronic address: klb9r@virginia.edu.
Kenneth L
KL
Brayman
D003663:Decision Trees; D004322:Drainage; D006801:Humans; D010146:Pain / Q000209:etiology / Q000601:surgery; D059408:Pain Management / Q000379:methods; D010180:Pancreatectomy; D050500:Pancreatitis, Chronic / Q000150:complications / Q000175:diagnosis / Q000601:surgery*
Chronic; Pancreas; Pancreatectomy; Pancreaticojejunostomy; Pancreatitis