[A new concept in the surgery of chronic pancreatitis (author's transl)]

Abstract

There is an obvious advantage to partial duodenopancreatectomy with occlusion of the pancreatic duct by prolamine (a rapidly solidifying aminoacid solution) for the prevention of recurrences, while preserving the stomach and proximal duodenum, in the treatment of severe destruction of the pancreas, localised to the head or generalised. The death rate of partial duodenopancreactectomy has been lowered from 8.5 to 2.3% since using this method. Compared with total duodenopancreatectomy which--according to the authors' earlier results carried a postoperative mortality of 20%--the operative risk has been reduced to a tenth. Taking into account the benign nature of chronic pancreatitis, on the other hand, and the extent of the operative operation, on the other, the present death-rate of 2.3% would appear reasonable. Occlusion of the pancreatic duct with prolamine in order to exclude any still present excretory pancreatic function in the residual pancreatic tissue has made all patients pain-free. No early recurrence has been observed.