A Clinical Analysis of Surgical treatment for the Chronic Pancreatitis

Abstract

Introduction: In general, Frey procedure is adopted for chronic pancreatitis (CP) with lesions in the head of the pancreas from the viewpoint of preservation of pancreatic function. However, depending on the condition, cases that select pancreatectomy may also be admitted. We examined cases of CP surgery in our hospital. Method: From 2009 to 2017, 21 patients were underwent surgery for CP in our department, and their clinical features were examined. Result: The cause of CP was alcoholic in 16 cases and idiopathic in 5 cases. The surgical procedure was selected as below, Frey operation: 13 cases, Partington operation: 1 case, PD: 4 cases, DP: 3 cases. Biliary jejunum anastomosis was added to 3 cases of Frey surgery. Pancreatic ductal jejunal anastomosis was added in 1 case of DP. PD was selected for two patients with a possibility of pancreatic cancer, and for two cases who formed pseudocysts in the head of the pancreas. Surgical-related death was not admitted. The pancreatic fistula of grade B or more was seen in 5 cases. 1 case who underwent Partington operation, pancreatitis at the head of the pancreas repeated, and portal vein thrombosis occurred concurrently. The pain remission rate of surgical treatment for CP was 95.2%. Preoperative diabetes mellitus was observed in 6 cases, but no cases newly developed diabetes after surgery were observed. Conclusion: The outcome of the surgical treatment for CP was good and acceptable. Basically, Frey operation was selected for CP of the head of the pancreas. But performing pancreatectomy sometimes improve the outcome according to the situation. So, it is necessary to select appropriate surgical procedure for CP.