[Treatment of chronic pancreatitis today: considerations on 133 observed cases]

Aim of the work is to define the present role of surgery in the treatment of chronic pancreatitis and the criteria of choice of procedures. The authors examined retrospectively 133 patients. They analyze the clinical, laboratory and instrumental features on which has been formulated the surgical indications. Patients treated surgically were those who have intractable pain, jaundice, intestinal obstructions and bleeding. The choice of the procedure is based on the seat and type of the anatomo-pathological lesions and on the features of Wirsung's duct. 54 of the 133 patients observed have been treated surgically or with interventional radiology. The authors carried out 19 resections, 30 drainage procedures, 1 pancreatic biopsy, 2 percutaneous drainage, 1 perendoscopic papillotomy. Neither mortality nor morbidity were observed after radiological and endoscopic procedures, while after surgery we observed 3.9% of mortality and 9.4 of total morbidity and 5.6% of specific morbidity, represented by a pancreatic leakage. The long term results were well in the patients who didn't take on alcohol. In conclusion the authors underline that the progresses of the medical treatment and the radiological and endoscopic procedures imply the decrease of number of patients undergoing surgical intervention. They remind that surgery maintain his importance and, when carried out with correct indications, permits to obtain an effective and lasting result of the symptomatology presented by the patient.