Long Term Follow-Up Results of Surgical Treatment for Chronic Pancreatitis

Ryuji Nakamura, Katsumi Amikura, Masao Kobari, Seiki Matsuno

First Department of Surgery, Tohoku University School of Medicine

During the last 30 years, 174 patients with chronic pancreatitis were treated surgically in our clinic. Operative procedures included side-to-side pancreaticojejunostomy in 64 patients, other pancreatic duct drainage procedures in 12, caudal pancreatectomy in 33, pancreaticoduodenectomy in 24, and others. A beneficial effect of the operation on abdominal pain was noted in 96% of the patients. There was no significant difference in the effect on pain among the types of surgery. The study of follow-up results showed an operative benefit in 85% of the patients. But in 15% of the patients (20 patients including 19 with alcoholic pancreatitis) poor results were obtained because of severe diabetes mellitus, alcohol abuse, analgetic addiction, and inappropriate surgery. There was no significant difference in the cumulative survival rate among the types of surgery and etiology of pancreatitis. Patients with diabetes mellitus at the time of the operation had 77% 5-year, 68% 10-year and 48% l5-year survival rates compared with an over 80% 20-year survival rate for patients with normal and impaired glucose tlerance. The difference between diabetes and either normal or impaired glucose tolerance is statistically significant. Diabetes mellitus is an important factor for long-term survival of surgically treated patients with chronic pancreatitis.

Key words
chronic pancreatitis, surgical treatment, survival rate

Reprint requests
Ryuji Nakamura First Department of Surgery, Tohoku University School of Medicine
1-1 Seiryo-machi, Aoba-ku, Sendai, 980 JAPAN

Accepted
July 3, 1991

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