ABSTRACT
Objective To investigate the surgical procedures for chronic pancreatitis associated with pancreatic duct stones.Methods The clinical data of 17 cases of chronic pancreatitis with pancreatic duct stones surgically treated were analyzed retrospectively.Results Of the 17 cases,13 had pancreatic duct stones in the head of the pancreas.4 had pancreaticolithiasis in the body and tail of the pancreas,six had additional choledocholithiasis.Surgical treatments included Roux-en-Y anastomosis of the pancreatic duct and jejunum in 6 cases(Partington procedure),anastomosis of pancreatic duct and stomach in 4 cases (Warren procedure).subtotal resection of the head of the pancreas with duodenal preservation in 3 cases (Beger's procedure).removal of the tail of pancreas with Roux-en-Y anastomosis of the distal pancreatic end to the iejunum in 3 cases(Duval's procedure),removal of the tail of pancreas and spleen with a Roux-en-Y anastomosis of the distal pancreatic end to ieiunum in 1 case.All 17 patients were cured,with complete relief of intractable abdominal pain in 15 cases.blood glucose was under eontrol in two out of six diabetics.Two cases suffered from postoperative pancreatic fistula.one patient died of pancreatic cancer 11 months after operation.Conclusion For patients with chronic pancreatitis and pancreaticolithiasis.surgical treatment should be highly individualized.We suggest drainage procedures for patients with dilatation of the pancreatic duct.Patients with no dilatation of the pancreatic duct and those with suspected carcinoma can be treated by partial pancreatectomy and Roux-en-Y pancreaticojejunostomy.Meanwhile effort must be applied to preserve the exocnne and endocrine pancreatic function vital for the patient's quality of life.