Surgical indications and techniques in the treatment of chronic pancreatitis

Forty-six patients operated on for chronic pancreatitis are reported. 3 (6.4%) underwent splanchnicectomy, 29 (59.2%) Roux-en-Y side-to-side pancreaticojejunostomy, 17 (34.6%) resective procedures (8 left hemipancreatectomy, 5 subtotal pancreatectomy, 3 pancreaticoduodenectomy, 1 total pancreatectomy). Overall postoperative morbidity was 13%: 29.4% after excisional surgery and 3.4% after drainage procedures. One patient treated by subtotal pancreatectomy died because of a hepatorenal syndrome. All the 3 patients treated by splanchnicectomy required resection within two years. The best results were obtained by pancreaticojejunostomy. Drainage procedures represent the operations of choice for chronic pancreatitis as long as correct indications exist. Splanchnicectomy has been discarded as a mean of pain relief because of pain recurrence with time.