[Surgical treatment of chronic pancreatitis with predominant cephalic involvement by double Wirsung duct diversion and restoration of permeability of the cephalic duct]

Abstract

The aim of this study is to assess the long-term results of an original surgical technique for the treatment of patients suffering from painful chronic pancreatitis. From 1981 to 1994, 54 patients with chronic painful pancreatitis were operated, by means of an original duct drainage procedure, named by the authors "double drainage" because it consists of a large transduodenal sphincterotomy and a long pancreatic duct, accompanied by repermeabilization of the cephalic pancreatic duct. This procedure was used exclusively for type I pancreatitis with major lesions in the head of the gland (calcified stones, narrowing of the ducts, inflammatory process). There were 40 men and 14 females in this series. No perioperative mortality and a low morbidity (22%) were observed. Mean follow-up in 52 patients was 56 months (median: 59.5 months). The 5- year actuarial survival was 85.2% and 81% were free of pain (91% when the pancreatic duct was dilated to > 6 mm) versus 63% when the pancreatic duct was (6 mm) (p < 0.01). These excellent results should serve as a baseline for any alternative treatment of this category of painful chronic pancreatitis patients.