[Long-term results in surgical treatment of chronic pancreatitis]

The work analyses 141 patients who were operated on for primary chronic pancreatitis which was caused by alcohol abuse in 84.4% of cases. The patients were divided into 2 subgroups according to the damage to the pancreas: 1--with dilatation of the pancreatic duct (49.6%), 2--without dilatation of the pancreatic duct (50.4%). Internal drainage of the duct system and their associated cysts was the main method of management of patients of the first group (52 patients). Patients of the second group were subjected to various resections of the pancreas (24) and occlusion of the ducts with a polymeric composition (19). In 38 cases the operation on the pancreas was complemented by operations on the biliary tract, stomach, and duodenum. Various postoperative complications were encountered in 27 (19.1%) patients, mortality was 5.7%. The results were most favorable after operations for internal drainage, resection of the organ, and external drainage of the cysts. Irrespective of the type of the operation, progressive fibrous degenerative changes of the gland with a statistically significant (p < 0.05) reduction of its size was noted in the late-term period. The method of occlusion of the duct system was marked by the greatest number of poor results. Strict argumentation of the indications for the use of each type of operation makes it possible to obtain good and satisfactory late-term results in 85.6% of cases.