Results of the Whipple Procedure in Combination with Pancreatic Duct Occlusion

Abstract

The results of operative treatment of chronic pancreatitis are disappointing, as shown in a literature survey by Gebhardt [7] (Table 1). The reason for the high number of recurrences — 30%-50% following pancreatic drainage procedures and 20%–30% following resection — lies in the continuing, independently progressing inflammation in the residual pancreas. In about 10–15 years this leads to complete atrophy and to a tissue alteration of the exocrine pancreas parenchyma. In 1984, Ammann et al. [1] were able to show that burning out of the glands in alcohol-induced chronic pancreatitis, in addition to an increasing calcification parallel with a reduction in the endocrine reserve capacity, leads ultimately to insulin-dependent diabetes mellitus. Surgical therapy can thus eliminate only the consequences and complications but not the cause of the pancreatitis.