[Surgical treatment of chronic pancreatitis. Retrospective study of 221 cases]

221 patients have been operated for chronic pancreatitis, secondary to alcoholic intoxication in 92% of cases. Surgery was performed for a complication of the disease (69%), for intractable pain (30%), or for a false diagnostic of cancer; 265 operations were done, among which 41% of resections, 18.5% of internal derivations, and 14.3% of external derivations. Post-operative morbidity was 23.4% and hospital mortality was 6.4%. Late mortality was 35.5%, pancreatitis being responsible for more than half of those deaths during the first three post-operative years. Iterative surgery was necessary in 37 cases. The risk of diabetes was multiplied by 3.2 after resection. Results were good in 50% of cases after 5 years. An important factor was the arrest of alcoholic intoxication. There was no significant difference between resection and derivation. Internal drainage should be preferred when possible. Surgery must be reserved to grave or invalidating complications of chronic pancreatitis.