Surgery for nonalcoholic chronic pancreatitis

There are few reports on operations in patients with nonalcoholic pancreatitis. Between 1985 and 1995 we operated on 58 such patients, 38 of whom were male and 20 female with a mean age of 35 years (range 5-72 years). The indications for operation were pain (n = 49), biliary obstruction (n = 12), duodenal obstruction (n = 10), portal hypertension (n = 11), cysts (n = 14), and pancreatic ascites (n = 3). Thirty-four patients with a dilated pancreatic duct underwent pancreaticojejunostomy; cysts were drained internally in eight, and biliary and duodenal obstruction was bypassed. Ten patients also underwent surgery for portal hypertension. Four (7%) patients died during the postoperative period. Of the remaining 54 patients, 48 (89%) were followed up for a median period of 63 months (range 6 months to 10 years). Six died: four of pancreatic cancer, one of cerebrovascular accident, and one of malnutrition. Of the 34 surviving patients operated for pain, 30 (88%) felt better, of whom 24 (71%) had complete relief of pain; 14 (41%) recorded a weight gain. Pancreatic decompression results in immediate and lasting pain relief in most patients with nonalcoholic chronic pancreatitis.