[Surgical treatment of autonomous chronic pancreatitis (apropos of 147 cases)]

Abstract

Surgery in chronic pancreatitis gives only poor results: 40 p. 100 of cures or long-term improvements. Apart from certain mistaken indications, three factors are associated with a poor prognosis: calcification, late operation, persistence of alcoholism. However, mechanical complications, such as jaundice, pyloric stenosis, digestive hemorrhage and pseudo-cyst, are the main undoubted indications for operation. The choice of operation depends mainly on the state of Wirsung's duct. Usually, either part of the gland is removed or an internal digestive fistula is performed. Removal of the left lobe of the pancreas gives good results. Cephalic duodeno-pancreatectomy which is satisfactory in the short term, does not give, in the long run, better results than those of drainage operations. Pseudo-cysts are treated by removal when situated in the body or the tail and a drainage operation in the cephalic form. Simple operations should be preferred.