Surgical Treatment for Pain Relief in Chronic Pancreatitis

Abstract

The surgical treatment of pain in chronic pancreatitis remains the main problem in the treatment of this disease, in a retrospective study of 52 operations conducted for the relief of pain in 37 patients the effects on pain and endocrine and exocrine pancreatic function were analyzed. Decompression-type operations led to relief of pain in 68% (15 of 22) of patients. No significant effect on pancreatic function was observed. Partial pancreatic resection (including Whipple's procedure) reduced pain in 48% (11 of 23) but induced deterioration of endocrine function in 27% (6 of 19) and of exocrine function in 44% (10 of 23). Total or subtotal pancreatectomy effectively reduced pain in all patients (seven of seven) but necessitated total exocrine substitution and insulin dependency in all patients. Late death as a consequence of the procedure was observed in three patients. Alternatives to conventional operations are now being explored, and segmental pancreatic autotransplantation was performed in two patients...