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Published on: December 14, 2019
Ductal drainage for chronic pancreatitis
1Department of Surgery, University of Texas Southwestern Medical Center, Dallas 75235.
Surgery
|February 1, 1989
Summary
Ductal drainage offers effective long-term pain relief for chronic pancreatitis patients, avoiding resection and preserving endocrine function. This surgical approach, particularly internal ductal drainage, is recommended despite potential complications like peptic ulcers.
Area of Science:
- Gastroenterology
- Surgical Oncology
- Pancreatic Surgery
Background:
- Chronic pancreatitis presents significant pain and morbidity.
- Pancreatic resection carries high mortality and risks endocrine dysfunction.
- Ductal drainage is an alternative for specific pancreatitis presentations.
Purpose of the Study:
- To review the operative experience of patients undergoing ductal drainage for chronic pancreatitis.
- To evaluate the long-term efficacy and complications of ductal drainage.
- To compare ductal drainage with pancreatic resection for specific indications.
Main Methods:
- Retrospective review of 23 patients with chronic or chronic relapsing pancreatitis.
- Patients treated for pain, without pseudocysts, followed for at least 5 years.
- Endoscopic retrograde cholangiopancreatography (ERCP) used to assess ductal anatomy.
Main Results:
- Internal ductal drainage provided good or excellent long-term pain relief in 90% of patients.
- Ductal drainage demonstrated lower mortality and preserved endocrine function compared to resection.
- Peptic ulcer disease was a frequent complication, necessitating further therapy.
Conclusions:
- Internal ductal drainage is a preferred surgical option for chronic pancreatitis with diffuse ductal dilation.
- The procedure offers significant pain relief and organ preservation.
- Prophylactic or early treatment for peptic ulcer disease is recommended post-surgery.
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