Surgical Treatment for Chronic Pancreatitis without Pancreatic Duct Dilation

Takehisa Hiraoka, Keiichiro Kanemitsu, Ikuo Kamimoto, Yoshimasa Miyauchi

First Department of Surgery, Kumamoto University Medical School

In 14 patients with chronic pancreatitis without dilatation of the main pancreatic duct, 7 had segmental lesions of the pancreas and 7 had diffuse lesions of the pancreas. All of the patients with the segmental lesion had relatively good pancreatic function and were relieved of pain by surgical treatment for only the segmental lesion. On the other hand, 6 of the 7 patients with the diffuse lesion had far advanced dysfunction of the pancreas. Two of the 7 patients were not freed from pain by drainage of the pancreatic duct and 2 other patients were relieved of pain by pancreatic resection but at the price of creating more severe insulin dependent diabetes. The remaining 3 patients underwent complete denervation of the pancreas and are still well more than 2 years after the operation. To control pain and to preserve pancreatic function as long as possible in such cases, this new surgical approach may offer a means of relieving pain with preservation of endocrine function in selected patients who have chronic pancreatitis without pancreatic duct dilation.

Key words
surgical treatment for chronic pancreatitis, chronic pancreatitis without pancreatic duct dilation, complete denervation of the pancreas

Reprint requests
Takehisa Hiraoka First Department of Surgery, Kumamoto University Medical School
1-1-1 Honjo, Kumamoto, 860 JAPAN

Accepted
July 3, 1991

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