Indications and Qualification of Pancreatic Resection in the Surgical Treatment for Chronic Pancreatitis

Mamoru Suzuki, Fujio Hanyu

Department of Gastroenterological Surgery, Tokyo Women's Medical College

Two hundred fifty-five patients with chronic pancreatitis received surgical treatment at our institution between 1968 and 1990. Early and late postoperative results were compared between 157 patients who received pancreatic resection (8 total pancreatectomy, 104 pancreas head resection, and 45 distal pancreatectomy) and 56 patients receiving pancreaticojejunostomy. Two operative deaths (1.8%) occurred after pancreas head resection, and one (0.9%) occurred after pancreaticojejunostomy. The mean follow-up time was 4.1 years after total pancreatectomy, 4.2 years after pancreas head resection, 5.6 years after distal pancreatectomy, and 5.5 years after pancreaticojejunostomy. More than 90% of the patients with each operation were free of pain postoperatively. Postoperative diabetes was present in 100% after total pancreatectomy, 23% after pancreas head resection, 51% after distal pancreatectomy, and, 44% after pancreaticojejunostomy. Five and 10-year survival rates were, respectively, 46% and, 25% after total pancreatectomy, 82% and, 72% after pancreas head resection, 92% and 66% after distal pancreatectomy, and, 82% and 62% after pancreaticojejunostomy. Late deaths occurred in 5 patients (63%), 8 patients (7.7%), 4 patients (8.8%), and 4 patients (7.4%) after total pancreatectomy, pancreas head resection, distal pancreatectomy, and pancreaticojejunostomy, respectively. These data suggest that pancreatic resection can be done safely and provid good long-term results in patients with chronic pancreatitis.

Key words
pancreatic resection, pancreaticojejunostomy, early and late postoperative results

Reprint requests
Mamoru Suzuki Department of Surgery, Tokyo Women's Medical College
8-1 Kawadacho, Shinjuku-ku, Tokyo, 162 JAPAN

Accepted
July 3, 1991

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