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Resection for chronic alcoholic pancreatitis

R G Keith, R H Sheppard, F G Saibil

    Canadian Journal of Surgery. Journal Canadien De Chirurgie
    |March 1, 1981
    PubMed
    Summary

    Surgical resection for chronic alcoholic pancreatitis offers pain relief, with total pancreatectomy providing complete pain resolution. However, various procedures carry risks including recurrent pancreatitis, steatorrhea, and diabetes.

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    Surgery·1995

    Area of Science:

    • Gastroenterology
    • Surgical Oncology
    • Endocrinology

    Background:

    • Chronic alcoholic pancreatitis significantly impacts quality of life due to persistent pain.
    • Surgical intervention is considered for refractory pain in chronic alcoholic pancreatitis.
    • Different pancreatectomy techniques carry varied outcomes and complications.

    Purpose of the Study:

    • To evaluate the long-term efficacy and complications of different pancreatic resection methods for chronic alcoholic pancreatitis.
    • To assess pain relief, recurrence of pancreatitis, metabolic sequelae, and alcohol use post-surgery.

    Main Methods:

    • A retrospective follow-up study of 19 patients with chronic alcoholic pancreatitis.
    • Patients underwent various resections: distal pancreatectomy, Whipple resection, 75% pancreatectomy, or total pancreatectomy.
    • Follow-up duration ranged from 7 to 81 months (mean 45 months).

    Main Results:

    • Complete pain relief was achieved in all patients after total pancreatectomy and in 4/7 after 75% pancreatectomy.
    • Recurrent acute pancreatitis was frequent after distal pancreatectomy.
    • Steatorrhea occurred in 14 patients, managed with enzyme replacement. Long-term weight gain was common, except after Whipple resection.
    • Diabetes developed in patients after 75% and distal pancreatectomy, and in all after total pancreatectomy, with complicated management in one due to alcohol recurrence.

    Conclusions:

    • Pancreatic resection can effectively relieve pain in chronic alcoholic pancreatitis, with total pancreatectomy offering the highest chance of complete pain resolution.
    • Despite pain relief, significant morbidity including steatorrhea, diabetes, and potential alcohol relapse requires careful long-term management.
    • The choice of resection technique should balance pain relief against the risk of metabolic and surgical complications.

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