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Ricardo L. Rossi, MD; Jan Rothschild, MD; John W. Braasch, MD; J. Lawrence Munson, MD; Stephen G. ReMine, MD

Arch Surg. 1987;122(4):416-420.

Abstract
• 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.

(Arch Surg 1987;122:416-420)

Author Affiliations
From the Department of Surgery, Lahey Clinic Medical Center, Burlington, Mass (Drs Rossi, Braasch, Munson, and ReMine); and the Department of Surgery, New England Medical Center Hospitals, Boston (Dr Rothschild).

Footnotes
Accepted for publication Jan 28, 1987.

Read before the 67th Annual Meeting of the New England Surgical Society, Dixville Notch, NH, Sept 26, 1986.

Reprint requests to Department of Surgery, Lahey Clinic Medical Center, 41 Mall Rd, Burlington, MA 01805 (Dr Rossi).

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