[Surgery of chronic pancreatitis. I. Late results after resection management]

From 1966 to 1985, 994 patients were treated for chronic pancreatitis. In 339 (34%), a resection of the pancreas was carried out. There were 166 left resections as compared to 175 right resections (Whipple, total duodenopancreatectomy). Almost half of the patients had already been operated on beforehand. The surgical lethality after partial duodenopancreatectomy could be lowered from 15% to 1.6%. After left resection, it continued without change to be 4% to 7%. Total duodenopancreatectomy and subtotal left resection were no longer carried out. 31% of the 246 patients followed up in a retrospective study died in the later course (mean period of follow-up observation: 6.5 years). Less than 10% of the patients died of complications due to pancreatitis. Three quarters of the patients maintained constant weight or gained weight. In half of the patients, there was a manifest diabetes mellitus postoperatively. 76% were free of pain postoperatively or had only slight symptoms. The late results are essentially determined by the readiness of the patients to adopt a disciplined style of life with reduction of alcohol consumption. This must be considered in the establishment of the indication for pancreatectomy in chronic pancreatitis.