Pancreatoduodenectomy in the management of chronic pancreatitis
R. L. Rossi, J. Rothschild, J. W. Braasch, J. L. Munson and S. G. ReMine
The records of 73 consecutive patients who underwent pancreatoduodenectomy
for chronic pancreatitis between 1960 and 1985 were reviewed. The median
size of the pancreatic duct was 5 mm. Two operative deaths (2.7%) occurred
early in the series. Eighty-eight percent, 86%, and 79% of the patients had
improvement in pain at six months, two years, and five years, respectively.
Diabetes was present preoperatively in 25% of patients and postoperatively
in 37%, 45%, and 69% of patients at six months, two years, and five years,
respectively. Pancreatic enzyme preparations were used preoperatively by
26% of patients; this use increased to 75% by five years. Only four of 17
late deaths could be related to diabetes or malnutrition. In most patients,
pancreatoduodenectomy achieves long-term pain improvement and permits
return to normal activities. Selection of patients is important to decrease
the late morbidity and mortality.
