Document Detail


The role of pancreaticoduodenectomy in the treatment of severe chronic pancreatitis.
MedLine Citation:
PMID:  10597055     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Chronic pancreatitis remains a debilitating disease with few definitive options for treatment. The purpose of this study was to evaluate the benefit of pancreaticoduodenectomy in the treatment of chronic pancreatitis. The results were evaluated by standard descriptive statistics. In a retrospective study, we reviewed the patients at a single institution undergoing pancreaticoduodenectomy between 1994 and 1997 for complications of chronic pancreatitis. Patients were evaluated for preoperative indication for surgery and perioperative morbidity and mortality, as well as long-term results. Thirty-two patients underwent pancreaticoduodenectomy for chronic pancreatitis; 56 per cent (18) underwent pylorus-preserving and 44 per cent (14) underwent classic pancreaticoduodenectomy. The mean age of these patients was 56+/-14.7 years (range, 23-79). All patients underwent preoperative CT scan and endoscopic retrograde cholangiopancreatography. The preoperative indication for surgery in 81 per cent (26) of these patients was intractable pain in the setting of a nondilated pancreatic duct. The other 19 per cent were treated for biliary/pancreatic duct stricture and pancreatic head fibrosis (mass suspicious of malignancy). Fifty-three per cent of the patients had a history of previous abdominal surgery. There were no perioperative deaths. The mean postoperative stay was 12.2+/-7.4 days. The postoperative morbidity rate was 31 per cent (10), consisting of 25 per cent with delayed gastric emptying, 3 per cent with pneumonia, and 3 per cent with wound infections. There was no occurrence of pancreatic fistulas. With a mean follow-up of 40 months (range, 10-52 months), 85 per cent reported a significant improvement in pain with 71 per cent being pain free and not requiring narcotics. Twenty per cent developed new-onset diabetes. The overall event survival rate at 5 years was 97 per cent. Thus, in a selected group of patients with severe chronic pancreatitis, resection of the head of the pancreas achieved relief of symptoms and was a safe and effective treatment for chronic pancreatitis.
Authors:
S M Vickers; C Chan; M J Heslin; A Bartolucci; J S Aldrete
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The American surgeon     Volume:  65     ISSN:  0003-1348     ISO Abbreviation:  Am Surg     Publication Date:  1999 Dec 
Date Detail:
Created Date:  1999-12-23     Completed Date:  1999-12-23     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0370522     Medline TA:  Am Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1108-11; discussion 1111-2     Citation Subset:  IM    
Affiliation:
Department of General Surgery, University of Alabama, School of Medicine, Birmingham 35294-0007, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Cholangiopancreatography, Endoscopic Retrograde
Chronic Disease
Constriction, Pathologic / physiopathology
Diabetes Mellitus / etiology
Female
Fibrosis
Follow-Up Studies
Gastric Emptying
Humans
Length of Stay
Longitudinal Studies
Male
Middle Aged
Pain, Intractable / physiopathology
Pancreas / pathology
Pancreatic Ducts / pathology
Pancreaticoduodenectomy* / adverse effects,  classification
Pancreatitis / physiopathology,  surgery*
Pneumonia / etiology
Retrospective Studies
Surgical Wound Infection / etiology
Survival Rate
Tomography, X-Ray Computed
Treatment Outcome

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


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