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[Chronic pancreatitis. A recent national experience with its surgical management]
R Rossi1, X de Arextzabala, G Watkins
1Departamento de Cirugía Digestiva, Pontificia Universidad Católica de Chile, Santiago, Chile.
Background:
The prevalence of chronic pancreatitis in Chile is not known and there is no local information about the surgical treatment of this disease.
Aim:
To review retrospectively the results of surgical treatment of chronic pancreatitis.
Material And Methods:
The charts of 17 patients (12 male), aged 7 to 65 years old, with chronic pancreatitis that were operated in three different Chilean regions, were reviewed.
Results:
Seven patients had previous endoscopic therapeutic procedures (papillotomy in 4 and stent placing in 3). Seven patients had been subjected to previous biliary surgical procedures. Indications for surgery were severe pain in 14 patients, the suspicion of a pancreatic carcinoma in 4 patients, an infected pseudocyst in one and massive bleeding of multiple pseudo-aneurysms in a pseudocyst in one patient. Twelve patients were subjected to decompressions and 5 to pancreatic resections. There was no operative mortality and one transient pancreatic fistula. After an average follow up of 22 months, pain improved in 94% of cases, pancreatic cancer was diagnosed in one patient and 79% of subjects gained weight. One patient became insulin dependent, one increased his insulin requirements and one had transient steatorrhea, since she could not afford pancreatic enzyme replacement therapy.
Conclusions:
The multidisciplinary approach of patients with chronic pancreatitis, with selective use of surgery, may greatly improve their quality of life.