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[Duodenum preserving resection of the head of the pancrease in therapy of pancreas divisum]
U Widmaier1, A Schmidt, W Schlosser
1Chirurgische Klinik I, Universität Ulm.
Der Chirurg; Zeitschrift Fur Alle Gebiete Der Operativen Medizen
|February 1, 1997
Summary
Pancreas divisum, a common finding during ERCP, can cause chronic pancreatitis (CP). Duodenum-preserving pancreatic head resection effectively relieved pain in all 12 patients, with some showing improved endocrine function.
Area of Science:
- Gastroenterology
- Surgical Oncology
- Pancreatic Diseases
Context:
- Pancreas divisum is found in 1-6% of patients undergoing ERCP.
- It can lead to acute relapsing and chronic pancreatitis (CP).
- Surgical intervention offers a potential recovery pathway for CP patients with pancreas divisum.
Purpose:
- To evaluate the efficacy of duodenum-preserving pancreatic head resection in patients with pancreas divisum and CP.
- To assess perioperative outcomes, pancreatic function, and long-term pain relief.
Summary:
- The study involved 12 patients with pancreas divisum and CP who underwent duodenum-preserving pancreatic head resection.
- No perioperative mortality occurred. Postoperative exocrine function was pathological in 10 patients, and endocrine function improved in two.
- Eleven patients were pain-free at a mean follow-up of 31 months. Two patients developed diabetes, and nine required exocrine function substitution.
Impact:
- Duodenum-preserving pancreatic head resection significantly reduced pain in patients with pancreas divisum and CP.
- The procedure may improve endocrine pancreatic function.
- Non-resecting or endoscopic therapies are discouraged for these patients.