[The diagnostic and surgical problems in chronic pancreatitis due to biliary calculosis]

Proceeding from personal clinical experience gained during many years of studies, the authors discuss the diagnostic and surgical problems of biliopancreatitis. In recent years biliary calculosis has been basic etiologic factor in 70 per cent of the cases; 76.8 per cent of the patients had complaints of long standing, while in the rest the history was shorter. The duration did not correspond to the morphologic findings. Only 43 per cent of the patients had clinical symptoms suggestive of accompanying pancreatitis, and echographic examination helped to establish the diagnosis in only 21 per cent of the cases. Two thirds (64 per cent) were patients in advanced and senile age, 5.8 per cent had severe preoperative complications and 52 per cent had systemic diseases affecting organs other than the liver and pancreas. The operations were primary in 169 patients (82 per cent) and repeat in 38 (18 per cent). The remote results were very good in 82 per cent, good in 9 per cent and satisfactory in 9 per cent. It is considered that treatment of chronic biliopancreatitis keeps on being surgical; endoscopic manipulations rather seldom produce ultimate therapeutic effect.