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Experience With Surgical Treatment

Russell A. Williams, MB, BS, FRACS; Bruce F. Caldwell, MB, BS; Samuel E. Wilson, MD

Arch Surg. 1982;117(4):408-412.

Abstract
Idiopathic hereditary pancreatitis is a rare form of primary chronic pancreatitis transmitted as an autosomal dominant trait with a variable clinical penetrance. We studied a Hispanic kindred of 23, seven of whom had the disease. In each of the seven cases, abdominal pain had started when the patient was a teenager. The disease was confirmed surgically in three patients, biochemically in three, and roentgenographically in one. No causes were determined. The three patients who had surgery each had a ten- to 30-year history of recurrent severe abdominal pain requiring multiple hospital admissions. In each the pancreatic duct had a "chain-of-lakes" appearance on endoscopic retrograde cholangiopancreatographic examination and was drained by longitudinal pancreatojejunostomy. There was no recurrence of symptoms after surgery. Retrograde drainage of the pancreatic duct reliably relieves the symptoms of idiopathic hereditary pancreatitis.

(Arch Surg 1982;117:408-412)

Author Affiliations
From the Surgical and Research Services, Veterans Administration Wadsworth Medical Center, Los Angeles (Drs Williams and Wilson), the Department of Surgery, University of California School of Medicine, Los Angeles (Drs Williams and Wilson) and the Department of Surgery, University of Sydney, Australia (Dr Caldwell).

Footnotes
Accepted for publication Nov 2, 1981.

Read at the Fifth Annual Surgical Symposium of the Association of Veterans Administration Surgeons, Minneapolis, May 13, 1981.

Reprint requests to Surgical Service (691/112K), Veterans Administration Wadsworth Medical Center, Los Angeles, CA 90073 (Dr Williams).

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