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Major pancreatic resections for chronic pancreatitis
D M Proca1, E C Ellison, D Hibbert
1Department of Pathology, Ohio State University, 410 W 10th Ave, Columbus, OH 43210, USA.
Archives of Pathology & Laboratory Medicine
|July 28, 2001
Summary
Major pancreatic resection for chronic pancreatitis (CP) offers low risk and relieves pain in about half of patients. Histology may indicate persistent pain, especially with alcoholic etiology or acute exacerbations.
Area of Science:
- Gastroenterology and Hepatology
- Surgical Oncology
- Pancreatic Diseases
Background:
- Indications for major pancreatic resections have expanded to include chronic pancreatitis (CP).
- Assessing clinical outcomes and histological findings in CP patients undergoing major pancreatic resection is crucial.
Purpose of the Study:
- To evaluate clinical findings and outcomes in patients undergoing major pancreatic resection for CP.
- To analyze histological findings and their association with persistent postoperative pain.
Main Methods:
- Retrospective review of charts and slides from 44 patients who underwent major pancreatic resections for CP (1989-1999).
- Analysis of perioperative mortality, morbidity, pain persistence, and histopathological findings.
Main Results:
- Low perioperative mortality (0%) and morbidity (4.5%).
- 57% of patients experienced persistent pain; higher rates in alcoholic CP and with total/Whipple resections.
- Histological findings like acinar necrosis and acute inflammation were more common in patients with persistent pain.
Conclusions:
- Major pancreatic resection for CP is safe with low morbidity and mortality.
- The procedure provides pain relief for nearly half of patients.
- Alcoholic etiology and histological signs of acute exacerbations may correlate with persistent pain.
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