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Surgery in Chronic Pancreatitis

  • J. R. Izbicki
  • C. Bloechle
  • J. C. Limmer
  • W. T. Knoefel

Abstract

Surgical treatment of chronic pancreatitis remains a major challenge. Most distressing for the patient and his relatives is the finding that, following the trauma and hazards of an operation, relief of symptoms, especially severe pain, has not been achieved. To the surgeon it is no less disturbing to realise that despite technical perfection, a time-consuming procedure has not benefited the patient as expected. Thus, the following main issues have to be considered carefully when surgical treatment of a patient suffering from chronic pancreatitis is planned.

Keywords

Chronic Pancreatitis Occupational Rehabilitation Severe Chronic Pancreatitis Beger Procedure Longitudinal Pancreaticojejunostomy 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. 1.
    Ebbehoj N, Svendsen LB, Madsen P (1984) Pancreatic tissue pressure in chronic obstructive pancreatitis. Scand J Gastroenterol 19:1066–1068.PubMedGoogle Scholar
  2. 2.
    Bockmann DE, Buechler M, Malfertheimer P, Beger HG (1988) Analysis of nerves in chronic pancreatitis. Gastroenterology 94:1459–1469.Google Scholar
  3. 3.
    Kloeppel G, Maillet B (1993) Pathology of acute and chronic pancreatitis. Pancreas 8:659–670.CrossRefGoogle Scholar
  4. 4.
    Ammann RW, Akovbiantz A, Largiader F, Schueler G (1984) Course and outcome of chronic pancreatitis. Gastroenterology 86:820–828.PubMedGoogle Scholar
  5. 5.
    Lankisch PG, Happe-Loehr A, Otto J, Creutzfeldt W (1993) Natural course in chronic pancreatitis. Digestion 54:148–155.PubMedCrossRefGoogle Scholar
  6. 6.
    Frey CF, Pitt HA, Prinz RA (1996) A plea for uniform reporting of patient outcome in chronic pancreatitis. Arch Surg 131:233–234.PubMedGoogle Scholar
  7. 7.
    Bloechle C, Izbicki JR, Knoefel WT, Kuechler T, Broelsch CE (1995) Quality of life in chronic pancreatitis: results after duodenum-preserving resection of the head of the pancreas. Pancreas 11:77–85.PubMedCrossRefGoogle Scholar
  8. 8.
    Warshaw AL (1984) Pain in chronic pancreatitis: patients, patience, and the impatient surgeon. Gastroenterology 86:987–989.PubMedGoogle Scholar
  9. 9.
    Izbicki JR, Bloechle C, Knoefel WT, Kuechler T, Binmoeller KF, Broelsch CE (1995) Duodenum-preserving resections of the head of the pancreas in chronic pancreatitis. A prospective randomized trial. Ann Surg 221:350–358.PubMedCrossRefGoogle Scholar
  10. 10.
    Taylor SM, Adams DB, Andersson MC (1991) Duodenal stricture: a complication of chronic fibrocalcific pancreatitis. South Med J 84:338–341.PubMedGoogle Scholar
  11. 11.
    Izbicki JR, Wilker DK, Waldner H, Rueff FL, Schweiberer L (1989) Thoracic manifestations of internal pancreatic fistulas: report of five cases. Am J Gastroenterol 84:265–271.PubMedGoogle Scholar
  12. 12.
    Warshaw AL, Jin G, Ottinger LW (1987) Recognition and clinical implications of mesenteric and portal vein obstruction in chronic pancreatitis. Arch Surg 122:410–415.PubMedGoogle Scholar
  13. 13.
    Frey CF, Suzuki M, Isaji S (1990) Treatment of chronic pancreatitis complicated by obstruction of the common bile duct or duodenum. World J Surg 14:59–69.PubMedCrossRefGoogle Scholar
  14. 14.
    Bernades P, Baetz A, Levy P, Belghiti J, Menu Y, Fekete F (1992) Splenic and portal venous obstruction in chronic pancreatitis. Dig Dis Sei 37:340–346.CrossRefGoogle Scholar
  15. 15.
    Little AG, Moossa AR (1981) Gastrointestinal hemorrhage from left-sided portal hypertension. Am J Surg 141:153–158.PubMedCrossRefGoogle Scholar
  16. 16.
    Büchler M, Friess H, Mueller MW, Wheatley AM, Beger HG (1995) Randomized trial of duodenum preserving pancreatic head resection versus pylorus preserving Whipple in chronic pancreatitis. Am J Surg 169:65–70.PubMedCrossRefGoogle Scholar
  17. 17.
    Bloechle C, Busch C, Tesch C et al. (1997) Prospective randomized study of drainage and resection on non-occlusive segmental portal hypertension in chronic pancreatitis. Br J Surg 84:477–482.PubMedCrossRefGoogle Scholar
  18. 18.
    Saeger HD, Schwall G, Trede M (1993) Standard Whipple in chronic pancreatitis. In: Beger HG, Buechler M, Malfertheimer P, (eds) Standards in pancreatic surgery. Springer, Berlin Heidelberg New York, pp 385–391.Google Scholar
  19. 19.
    White TT, Hart MJ (1979) Pancreaticojejunostomy versus resection in the treatment of chronic pancreatitis. Am J Surg 138:129–134.PubMedCrossRefGoogle Scholar
  20. 20.
    Nealon WH, Thompson JC (1993) Progressive loss of pancreatic function in chronic pancreatitis is delayed by main pancreatic duct decompression. Ann Surg 217:458–468.PubMedCrossRefGoogle Scholar
  21. 21.
    Bradley EL (1982) Pancreatic duct pressure in chronic pancreatitis. Am J Surg 144:313–316.PubMedCrossRefGoogle Scholar
  22. 22.
    Ebbehoj N, Borly J, Madsen P, Svendsen LB (1990) Pancreatic tissue pressure and pain in chronic pancreatitis. Pancreas 4:556–558.Google Scholar
  23. 23.
    Frey CF, Amikura K (1994) Local resection of the head of the pancreas combined with longitudinal pancreaticojejunostomy in the management of patients with chronic pancreatitis. Ann Surg 220:492–507.PubMedCrossRefGoogle Scholar
  24. 24.
    Frey CF (1990) Why and when to drain the pancreatic ductal system. In: Beger HG, Buechler MW, Ditschuneit H, Malfertheiner P (eds) Chronic pancreatitis. Springer, Berlin Heidelberg New York, pp 415–425.Google Scholar
  25. 25.
    Limmer JC, Knoefel WT, Bloechle C, Izbicki JR (1996) Correlation between intraductal and intraparenchymatous pancreatic pressure and pain in chronic pancreatitis. Int J Pancreatol 19:237 (abstract).Google Scholar
  26. 26.
    Karanjia ND, Widdison AL, Leung F, Alvarez C, Lutrin FJ, Reber HA (1994) Compartment syndrome in experimental chronic obstructive pancreatitis: effect of decompressing the main pancreatic duct. Br J Surg 81:259–264.PubMedCrossRefGoogle Scholar
  27. 27.
    Prinz RA, Greenlee HB (1981) Pancreatic duct drainage in 100 patients with chronic pancreatitis. Ann Surg 194:313–320.PubMedCrossRefGoogle Scholar
  28. 28.
    Adams DB, Ford MC, Anderson MC (1994) Outcome after lateral pancreaticojejunostomy for chronic pancreatitis. Ann Surg 219:481–489.PubMedCrossRefGoogle Scholar
  29. 29.
    Markowitz JS, Rattner DW, Warshaw AL (1994) Failure of symptomatic relief after panreatico-jejunal decompression for chronic pancreatitis. Arch Surg 129:374–380.PubMedGoogle Scholar
  30. 30.
    Keith RG, Keshavjee SH, Kerenyi NR (1985) Neuropathology of chronic pancreatitis in humans. Can J Surg 28:207–211.PubMedGoogle Scholar
  31. 31.
    Beger HG, Buechler M, Bittner R, Oettinger W, Roscher R (1989) Duodenum-preserving resection of the head of the pancreas in severe chronic pancreatitis. Ann Surg 209:273–278.PubMedCrossRefGoogle Scholar
  32. 32.
    Puestow CB, Gillesby WJ (1958) Retrograde surgical drainage of pancreas for chronic pancreatitis. Arch Surg 76:898–906.Google Scholar
  33. 33.
    Whipple AO (1946) Radical surgery for certain cases of pancreatic fibrosis associated with calcareous deposits. Ann Surg 124:991–1006.CrossRefGoogle Scholar
  34. 34.
    Frey CF, Child CG, Fry W (1976) Pancreatectomy for chronic pancreatitis. Ann Surg 184:403–413.PubMedCrossRefGoogle Scholar
  35. 35.
    Traverso LW, Longmire WP (1978) Preservation of the pylorus in pancreaticoduodenectomy. Surg Gynecol Obstet 146:959–962.PubMedGoogle Scholar
  36. 36.
    Sawyer R, Frey CF (1994) Is there still a role for distal pancreatectomy in surgery for chronic pancreatitis? Am J Surg 168:6–9.PubMedCrossRefGoogle Scholar
  37. 37.
    Beger HG, Buechler M (1990) Duodenum-preserving resection of the head of the pancreas in chronic pancreatitis with inflammatory mass in the head. World J Surg 14:83–87.PubMedCrossRefGoogle Scholar
  38. 38.
    Büchler M, Malfertheiner P, Friess H, Beger HG (1993) Chronic pancreatitis with inflammatory mass in the head of the pancreas: a special entity? In: Beger HG, Buechler M, Ditschuneit H, Malfertheiner P (eds) Chronic pancreatitis. Springer, Berlin Heidelberg New York, pp 41–46.Google Scholar
  39. 39.
    Büchler MW, Friess H, Bittner R et al. (1997) Duodenum-preserving pancreatic head resection: long-term results. J Gastrointest Surg 1:13–19.PubMedCrossRefGoogle Scholar
  40. 40.
    Beger HG, Krautzberger W, Bittner R, Buechler M, Limmer J (1985) Duodenum-preserving resection of the head of the pancreas in patients with severe chronic pancreatitis. Surgery 97:467–473.PubMedGoogle Scholar
  41. 41.
    Frey CF, Smith GJ (1987) Description and rationale of a new operation for chronic pancreatitis. Pancreas 2:701–707.PubMedCrossRefGoogle Scholar
  42. 42.
    Izbicki JR, Bloechle C, Knoefel WT et al (1994) Complications of adjacent organs in chronic pancreatitis managed by duodenum-preserving resection of the head of the pancreas. Br J Surg 81:1351–1355.PubMedCrossRefGoogle Scholar
  43. 43.
    Wilker DK, Izbicki JR, Knoefel WT, Geissler K, Schweiberer L (1990) Duodenum-preserving resection of the head of the pancreas in treatment of chronic pancreatitis. Am J Gastroenterol 85:1000–1004.PubMedGoogle Scholar
  44. 44.
    Partington PF, Rochelle RE (1960) Modified Puestow procedure for retrograde drainage of the pancreatic duct. Ann Surg 152:1037–1042.PubMedCrossRefGoogle Scholar
  45. 45.
    Izbicki JR, Bloechle C, Broering DC, Kuechler T, Broelsch CE (1997) Longitudinal V-shaped excision of the ventral pancreas for small duct disease in severe chronic pancreatitis. Ann Surg (in press).Google Scholar
  46. 46.
    Buechler M, Friess H, Isenmann R, Bittner R, Beger HG (1993) Duodenum-preserving resection of the head of the pancreas: the Ulm experience. In: Beger HG, Büchler M, Malfertheimer P (eds) Standards in pancreatic surgery. Springer, Berlin Heidelberg New York, pp 436–449.Google Scholar
  47. 47.
    Izbicki JR, Bloechle C, Knoefel WT, Binmoeller KF, Soehendra N, Broelsch CE (1997) Drainage versus Resektion in der chirurgischen Therapie der chronischen Kopfpankreatitis: eine randomisierte Studie. Chirurgie 68:369–377.CrossRefGoogle Scholar
  48. 48.
    Klempa I, Spatny M, Menzel J et al. (1995) Pankreasfunktion und Lebensqualität nach Pankreaskopfresektion bei der chronischen Pankreatitis. Chirurgie 66:350–359.Google Scholar
  49. 49.
    Martin RF, Rossi RL, Leslie KA (1996) Long-term results of pylorus-preserving pancreatoduodenectomy for chronic pancreatitis. Arch Surg 131:247–252.PubMedGoogle Scholar
  50. 50.
    Stapleton GN, Williamson RCN (1996) Proximal pancreatoduodenectomy for chronic pancreatitis. Br J Surg 83:1433–1440.PubMedCrossRefGoogle Scholar
  51. 51.
    Trede M, Schwall G, Saeger HD (1990) Survival after pancreatoduodenectomy. Ann Surg 211:447–458.PubMedCrossRefGoogle Scholar
  52. 52.
    Trede M, Schwall G (1988) The complications of pancreatectomy. Ann Surg 207:39–47.PubMedCrossRefGoogle Scholar
  53. 53.
    Jalleh RP, Williamson RC (1992) Pancreatic exocrine and endocrine function after operations for chronic pancreatitis. Ann Surg 216:656–662.PubMedCrossRefGoogle Scholar
  54. 54.
    Bradley EL (1987) Long-term results of pancreatojejunostomy in patients with chronic pancreatitis. Am J Surg 153:207–213.PubMedCrossRefGoogle Scholar
  55. 55.
    Greenlee HB, Prinz RA, Aranha GV (1990) Long-term results of side-to-side pancreatico-jejunostomy. World J Surg 14:70–76.PubMedCrossRefGoogle Scholar
  56. 56.
    Frey CF, Suzuki M, Isaji S, Zhu Y (1989) Pancreatic resection for chronic pancreatitis. Surg Clin North Am 69:499–528.PubMedGoogle Scholar
  57. 57.
    Warshaw AL (1985) Conservation of pancreatic tissue by combined gastric, biliary, and pancreatic duct drainage for pain from chronic pancreatitis. Am J Surg 149:563–569.PubMedCrossRefGoogle Scholar
  58. 58.
    Prinz RA, Aranha GV, Greenlee HB (1985) Combined pancreatic duct and upper gastrointestinal and biliary tract drainage in chronic pancreatitis. Arch Surg 120:361–366.PubMedGoogle Scholar
  59. 59.
    Frey CF, Leary BF (1993) Local resection of the head of the pancreas combined with longitudinal pancreaticojejunostomy: an update. In: Beger HG, Buechler M, Malfertheiner P (eds) Standards in pancreatic surgery. Springer, Berlin Heidelberg New York, pp 471–482.Google Scholar
  60. 60.
    Schipper H (1983) Why measure quality of life? Can Med Assoc J 128:1367–1369.PubMedGoogle Scholar
  61. 61.
    Bassi C, Falconi M, Caldiron E et al. (1997) Surgical drainage and bypass. In: Izbicki JR, Binmoeller KF, Soehendra N (eds) Chronic pancreatitis: an interdisciplinary approach. De Gruyter, Berlin, pp 127–133.Google Scholar

Copyright information

© Springer-Verlag London Limited 1999

Authors and Affiliations

  • J. R. Izbicki
  • C. Bloechle
  • J. C. Limmer
  • W. T. Knoefel

There are no affiliations available

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