Modifications of duodenum-preserving pancreatic head resection as surgical option in patients with chronic pancreatitis

Surgery for chronic pancreatitis has gained wide acceptance because of excellent results regarding pain alleviation and control of complications arising from adjacent organs. After the introduction of duodenum-preserving pancreatic head resection by Beger almost three decades ago, many modifications have been proposed, evaluated and compared. Besides the Beger and Frey procedure, none of the modifications have been properly evaluated in a prospective randomized trial. Both procedures managed to relief the outlined problems while achieving low operative mortality and morbidity. Apart from partial pancreatoduodenectomy, only the operations according to Beger and Frey can be considered standard procedures in chronic pancreatitis.