[Surgery of chronic pancreatitis]

Between 1982 and 1988 47 patients underwent surgery for chronic pancreatitis at our institution. The main etiological factor was alcohol (41 cases). The mean age of the patients with alcohol-induced chronic pancreatitis was 15 years below that of the other patients. Calcifications were found in 27 patients at the time of surgery. Calcifications and exocrine insufficiency increased from 40% and 27% to 80% and 79% respectively if the history was shorter than 5 years or more than 10 years. The main indications for surgery were cholestatic jaundice (23 cases) and pseudocysts (22 cases), while only 6 patients had surgical treatment for pain alone. Only one of seven recurrences of chronic pancreatitis were in a patient with a history of more than ten years. Operative mortality was 4%. The length of the history of chronic pancreatitis influences the indication for surgery, the surgical technique and postoperative prognosis. Studies comparing different operative techniques are only of value if they take the natural history of the disease into account.