Indications and surgical treatment of chronic pancreatitis

BACKGROUND:Some patients with chronic pancreatitis (CP)may require surgery mainly because of intractable pain,suspicion of malignancy,or complications related to CP.This study aimed to analyze the efficacy of surgical treatment for patients with CP in terms of pain relief, control of local complications,and pancreatic endocrine/ exocrine function. METHODS:Twenty-six patients with CP were treated surgically at our hospital from June 1985 to November 2005.The clinical data of these patients were analyzed retrospectively. RESULTS:The follow-up time ranged from 8 to 130 months with a median of 60.6 months.No patients were lost to follow-up.All patients had improvement of clinical symptoms such as abdominal pain,steatorrhea and weight loss,to some degree,especially pain relief in patients with good dilation and high pressure of the main pancreatic duct.The endocrine and exocrine functions were not alleviated in all patients,otherwise the impaired glucose tolerance was improved in 8(30.8%),15(57.7%) maintained the same body weight,one(3.8%)had an acute attack of CP,and 2(7.7%)developed pancreatic carcinoma in the 16th and 28th month postoperatively and died within 3 years after operation for CP.The 1-,3-,5-year pain-free rates of CP patients were 96.2%(25/26),88.5% (23/26)and 84.6%(22/26),respectively. CONCLUSIONS:In selected patients with CP,surgical treatment is a safe procedure and can effectively relieve pain and control local complications;also,it is helpful to improve the quality of life for patients with pancreatitis, and to control the development of this disease.