Pancreatico-jejunostomy in chronic pancreatitis. An appraisal of 29 cases.

Pancreatico-jejunostomy end to side after resection of the pancreatic tail, or side to side following longitudinal cleaving of the pancreatic duct, was performed in 29 patients suffering from chronic relapsing or acute recurring pancreatitis. A follow-up study with observation time ranging from 6 months to 10 years is presented. The patients were allotted to three groups according to the severity and extent of the inflammatory involvement at operation. The diagnostic findings obtained at the preoperative evaluation correlated well to these groupings. In some patients, however, the inflammatory process was mainly confined to the ductal system, as revealed by pancreatography, while in others the changes were most marked in the parenchyma, as found at histologic examination. 21 caudal pancreatico-jejunostomies and 8 longitudinal anastomoses were performed. Overall results were excellent in 20 patients, good in 6, fair in 3, and poor in none. The rate of postoperative complications was low; no mortality, one spontaneously healed anastomosis insufficiency, subphrenic abscess developed in 2 instances and postoperative diabetes in 5. Only one patient had a recurrent attack of acute pancreatitis postoperatively. Re-anastomosis was successfully performed.