Modifications of the duodenum-preserving pancreatic head resection

Surgery for chronic pancreatitis has gained wide acceptance because of excellent results regarding pain alleviation and control of complications arising from adjacent organs. After the introduction of the duodenum preserving pancreatic head resection by Beger almost three decades ago, many modifications have been proposed, evaluated and compared. This article reviews the variety of operations, the reported results and potential advantages. Besides the Beger- and Frey procedure, none of the modifications have been properly evaluated in a prospective randomised trial. Both procedures managed to relief the outlined problems while achieving low operative mortality and morbidity. Only the operations according to Beger and Frey can be considered standard procedures in chronic Pancreatitis.