Document Detail


Long-term results following different extent of resection in chronic pancreatitis.
MedLine Citation:
PMID:  11462943     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND/AIMS: To evaluate, whether the indication related varying extent of resection in chronic pancreatitis has a predictable impact on long-term outcome. METHODOLOGY: One hundred and twenty-six patients consecutively underwent surgery for chronic pancreatitis from March 1987 to September 1997. Three treatment categories were defined: Pancreatoduodenectomy, duodenum-preserving resection and drainage procedures, and left-sided pancreatectomy. Main outcome measures were late mortality, pain scores preoperatively and at follow-up, body-weight change, percentage of insulin dependent diabetes, patient's and physician's satisfaction with surgery. RESULTS: Forty-one patients underwent pancreatoduodenectomy, 59 drainage procedures, and 26 left-sided pancreatectomy, respectively. Hospital mortality was 1 (2.4%), 4 (6.8%), and 1 (3.8%) (P = NS), totaling 4.8%. After an average follow-up of 5.2 years, late mortality was 10 (24.4%), 9 (15.3%), and 4 (15.4%) (P = NS) for a total of 23 (18.3%). Two patients (1.6%) died of unsuspected pancreatic cancer. Three patients (2.4%) had to be reoperated upon for pain relapse. The mean pain score was 8.8 preoperatively and 2.1 at late follow-up and not different among groups. Body-weight gain averaged 3.0, 4.0, and 3.4 kg, with no significant differences. Percentage of insulin dependency in all patients rose from 14% prior to surgery to 30% at reevaluation, and was very similar in all treatment categories. CONCLUSIONS: The different kind and level of invasiveness of the surgical procedures did not significantly influence the late outcome. High rates of late mortality and deterioration of endocrine function are to a greater extent sequelae of comorbidity and the progression of the underlying pancreatic disease.
Authors:
J W Heise; M Katoh; R Lüthen; H D Röher
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Publication Detail:
Type:  Comparative Study; Evaluation Studies; Journal Article    
Journal Detail:
Title:  Hepato-gastroenterology     Volume:  48     ISSN:  0172-6390     ISO Abbreviation:  Hepatogastroenterology     Publication Date:    2001 May-Jun
Date Detail:
Created Date:  2001-07-20     Completed Date:  2002-01-16     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8007849     Medline TA:  Hepatogastroenterology     Country:  Greece    
Other Details:
Languages:  eng     Pagination:  864-8     Citation Subset:  IM    
Affiliation:
Department of General and Trauma Surgery, Heinrich-Heine-University, Moorenstr. 5, 40225 Düsseldorf, Germany. heisejh@uni-duesseldorf.de
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MeSH Terms
Descriptor/Qualifier:
Adult
Cause of Death
Chronic Disease
Drainage
Female
Follow-Up Studies
Hospital Mortality
Humans
Male
Middle Aged
Pancreatectomy*
Pancreaticoduodenectomy*
Pancreatitis / mortality,  surgery*
Postoperative Complications / mortality
Retrospective Studies
Survival Rate
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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