Chronic pancreatitis.

Chronic pancreatitis is marked by recurrent bouts of pain, complications of pancreatitis, and progressive exocrine and endocrine dysfunction. Objective complications are generally well managed, although they do not alter the natural or progressive course of the disease. Treatment of palpable pseudocysts is varied, and the multiple surgical alternatives are equally effective, since most pancreas function until the pseudocyst decompresses. For patients with recurrent and/or persisting pain, selection of candidates is as important as selection of operations. The goal of preserving as much parenchyma as possible and doing decompressive procedures is attractive for this reason alone. Success, as measured by relief of pain and ability to return to work, is dependent upon cessation of abuse of alcohol and other drugs and perhaps progressive dysfunction of the pancreas.