Progress in Surgical Approach for acute and Chronic Pancreatitis

Seiki Matsuno

First Department of Surgery, Tohoku University School of Medicine

The role of and indication for a surgical approach for acute and chronic pancreatitis are discussed in this paper. For patients with acute pancreatitis, a surgical approach is accepted in cases complicated by infected pancreatic necrosis, a pancreatic abscess and an acute pseudocyst. Some patients with necrotizing pancreatitis will become secondarily infected. The procedure of surgical intervention for infected pancreatic and peripancreatic necrosis is necrosectomy with sufficient drainagae such as closed lavage or open drainage. Pancreatic abscesses and infected pseudocysts require a different form of management than infected pancreatic necrosis. New surgical procedures have been introduced recently in the field of chronic pancreatitis. They are called Beger's procedure and Frey's procedure. There is a tendency to choose pancreatic function-preserving surgery for patients with chronic pancreatitis. Frey's procedure, longitudinal pancreatico-jejunostomy with coring out of the head of the pancreas, is preferable as a safer and more effective procedure for pain relief.

Key words
acute pancreatitis, chronic pancreatitis, necrosectomy

Reprint requests
Seiki Matsuno First Department of Surgery, Tohoku University School of Medicine
1-1 Seiryocho, Aoba-ku, Sendai, 980 JAPAN

Accepted
June 12, 1996

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