[Treatment of chronic pancreatitis by left resection of the pancreas (author's transl)]

Abstract

Report on 143 left resections of the pancreas for chronic pancreatitis. Good late results (81% of all patients improved or symptom-free) can be obtained by this method only in corpus-cauda-pancreatitis. Because of better results the 80-95%-resection should be preferred to the 40-80%-resection. In diffuse pancreatitis, however, a poor result is obtained in 55% of all operations. The same can be observed in cases where the main inflammatory lesion is located in the head of the pancreas and where in addition to the left resection an end-to-end pancreatico-jejunostomy is performed. In this case the Whipple's procedure should be preferred which can be combined with an intraoperative occlusion of the duct system in the pancreatic tail in order to prevent recidivation of pancreatitis. Contrary to the partial duodenopancreatectomy the left resection of the pancreas postoperatively leads to an increase of diabetes mellitus (41%).