[Comparative study of pancreatic head resection in chronic pancreatitis]

Between 1991 and 1998 the authors performed 21 pylorus-preserving pancreatoduodenectomies (PPPD), 32 Beger and 13 Frey procedures in chronic pancreatitis with inflammatory head enlargement. The pre- and intraoperative data, as well as the postoperative early and late results were also compared. The preoperative clinical features and the intraoperative morphology were similar in the three groups. Considering the operative and late mortality and the reoperation there was no statistical difference between the procedures. The postoperative hospitalization time was the shortest after the duodenum-preserving pancreatic head resections (Beger and Frey). While the rate of early complications was significantly higher after PPPD, there was no difference in the rate of late complications between the groups. Although each operation gave similarly good late results (freedom from pain, weight gain, exocrine function, quality of life), the condition of the patients was better and the development rate of diabetes was lower (1/27), after Beger procedure, that after PPPD (6/14). Consequently the duodenum-preserving pancreatic head resections seem to be more advantageous, than the PPPD. Nevertheless the latter procedure is the only possibility in some cases.