[Surgical treatment of chronic pancreatitis without pancreatic duct dilation]

In 11 patients with chronic pancreatitis without dilation of the main pancreatic duct, 4 had segmental lesions of the pancreas and 7 had diffuse lesions of the pancreas. Patients with the segmental lesion had a relatively good pancreatic function and were relieved from pain by surgical treatment for the segmental lesion. On the other hand, patients with the diffuse lesion had far advanced dysfunction of the pancreas and were not improved by drainage operation of the pancreatic duct. For such cases, total or near total pancreatectomy has been indicated to relieve pain at the price of creating insulin dependent diabetes. To control pain and to reserve pancreatic function as long as possible in these cases, we performed the resection of all the pancreatic nervous plexus for such 3 patients and have obtained good results, although follow-up periods are still short. This new approach may offer a means of relieving pain with preservation of endocrine function in selected patients with chronic pancreatitis, especially in patients who have not dilated pancreatic duct.