Operative mode based on clinicopathologic features in patients with chronic pancreatitis / 中国普通外科杂志

ABSTRACT

ObjectiveTo classify chronic pancreatitis (CP) based on pathological features and evaluate the benefits of different surgical procedures according to the pathological forms. Methods Forty CP cases during recent 9 years who underwent surgical therapy were retrospectively reviewed in association with clinicopathological analysis. Results Postoperative pain-relief rate was 79.16% in patients treated with longitudinal pancreaticojejunostomy(LPJ). In cases without enlarged pancreatic head or diverticulum of duodenum, postoperative pain-relief rate was 86%.Postoperative pain-relief rate was high by Whipple′s procedure, pylorus-preserving pancreaticoduodenectomy or Beger duodenum-preserving pancreatic head resection,while postoperative diabetes mellitus developed in 22%.Conclusions Both pathological form and operative procedure were factors influencing outcomes of CP.LPJ is still a main surgery for most CP patients with pancreatic fibrosis and dilated pancreatic duct and pancreatic stone.Some patients of CP with enlarged pancreatic head, hyperplasia of pancreatic parenchyma and pancreatic duct epithelia or complicated with diverticulum of the duodenum should be treated with resections targeting at the head of the pancreas.