Duodenum-Preserving Resection of the Head of the Pancreas with Complete Denervation of the Body and Tail of the Pancreas in Severe Chronic Pancreatitis

Hiroyuki Katoh, Eiji Shimozawa, Shunichi Okushiba, Kimihiro Nakajima, Yutaka Nakamura, Haruchika Ikenaga, Tatsuzo Tanabe

Second Department of Surgery Hokkaido University School of Medicine

In 30 patients with severe chronic pancreatitis, duodenum-preserving resection of the head of the pancreas with denervation of the left pancreas was performed. The objective of this surgical therapy is excision of the inflammatory tumor in the region of the head of the pancreas and cutting off of all nerve fibers of the body and tail of the pancreas. Reconstruction with drainage of the pancreatic secretion from the left pancreas into the upper intestinal tract takes place through end-to-side or side-to-side jejunal loop anastomosis. The limited operative intervention at the head of the pancreas and the preservation of the duodenum explain the preservation of the endocrine and exocrine function of the pancreas. As a result of the operation 85.7% of the patients were completely free of abdominal pain and 75% returned to their former occupation. During the late follow-up period, glucose metabolism was unchanged or improved in 70% of the patients. In 7 patients, there was stenosis with wall rigidity in the common bile duct. In these patients, common bile duct-duodenal anastomosis was carried out. In 3 patients a Partington modification was performed between the left pancreas and the jejunal interponate.

Key words
chronic pancreatitis, pancreas head resection, denervation of left pancreas

Reprint requests
Hiroyuki Katoh Second Department of Surgery, Hokkaido University School of Medicine
N14 W5 Kita-ku, Sapporo, 060 JAPAN

Accepted
July 3, 1991

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