The European journal of surgery = Acta chirurgica · 2000
Changing trends in operations for chronic pancreatitis: a 22-year experience.
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Sakorafas G H, Sarr M G
Аннотация
OBJECTIVE: To report the evolution of methods of surgical treatment of chronic pancreatitis.
DESIGN: Retrospective analysis.
SETTING: Private clinic, USA.
SUBJECTS: 448 consecutive patients who were operated on for chronic pancreatitis.
INTERVENTIONS: Resection (n = 286) or drainage of the duct (n = 162).
MAIN OUTCOME MEASURE: Changes over the 22-year period.
RESULTS: There was a change towards resection after 1985 (195/238, 59%, from 1976-90 compared with 91/120, 76%, from 1991-97), partly because of suspicions of malignancy. In recent years (1991-97) pylorus-preserving pancreaticoduodenectomy has come to be preferred over classic resection including antrectomy (22/36, 61%, compared with 11/69, 16%). Eight duodenum-preserving resections have been done since 1994.
CONCLUSIONS: More resections, particularly proximal pancreatectomies, are done nowadays. Lateral pancreaticojejunostomy has become the preferred drainage procedure, and pylorus-preserving pancreaticoduodenectomy is favoured over classic pancreaticoduodenectomy.
DESIGN: Retrospective analysis.
SETTING: Private clinic, USA.
SUBJECTS: 448 consecutive patients who were operated on for chronic pancreatitis.
INTERVENTIONS: Resection (n = 286) or drainage of the duct (n = 162).
MAIN OUTCOME MEASURE: Changes over the 22-year period.
RESULTS: There was a change towards resection after 1985 (195/238, 59%, from 1976-90 compared with 91/120, 76%, from 1991-97), partly because of suspicions of malignancy. In recent years (1991-97) pylorus-preserving pancreaticoduodenectomy has come to be preferred over classic resection including antrectomy (22/36, 61%, compared with 11/69, 16%). Eight duodenum-preserving resections have been done since 1994.
CONCLUSIONS: More resections, particularly proximal pancreatectomies, are done nowadays. Lateral pancreaticojejunostomy has become the preferred drainage procedure, and pylorus-preserving pancreaticoduodenectomy is favoured over classic pancreaticoduodenectomy.