Diario del páncreas Acceso abierto

Abstracto

Effectiveness of Elective Surgery in Patients with Chronic Pancreatitis

Kyohei Abe, Tomoyoshi Okamoto, Michinori Matsumoto, Yasuro Futagawa, Katsuhiko Yanaga

Background Medications and/or endoscopic therapy constitute first-line treatment for chronic pancreatitis; however, some patients remain refractory to conservative treatment. There are reports of surgical treatment for patients with chronic pancreatitis and their effectiveness, but few studies have investigated postoperative prognosis. Methods We investigated 15 patients (12 with chronic pancreatitis and 3 with (preoperatively diagnosed pancreatic tumor) between 2003 and 2019. Patients were aged 40–80 years (median 56 years, male: female ratio 12:3). Notably, 2, 10, and 3 patients underwent pancreaticoduodenectomy, distal pancreatectomy, and pancreaticojejunostomy, respectively. We evaluated preoperative diagnoses, operative procedures, short-term complications, surgical outcomes, long-term disease course, and prognosis based on medical findings. Results No operative mortality occurred however, 5 patients developed postoperative complications (pancreatic leakage and pseudocyst and pneumonia). Three people diagnosed with pancreatic cancer before surgery had no symptoms of pancreatitis, but postoperative histopathological examination revealed that these patients had tumor-forming pancreatitis. No postoperative recurrence occurred in any of the 12 patients with recurrent chronic pancreatitis. Chronic pancreatitis was attributed to preoperative alcohol consumption in 9 patients; 5 of them resumed alcohol consumption postoperatively. Notably, 3 patients developed hepatic cirrhosis and esophageal varices and died of hepatic failure (1 patient), pancreatic cancer (2 patients). Prognosis was good in patients without pre-or postoperative alcohol consumption. Conclusion Surgical treatment successfully controlled abdominal pain in patients with recurrent pancreatitis. Pre- and postoperative alcohol abstinence and close follow-up for cancer should be emphasized to reduce the risk of postoperative liver disease and pancreatic cancer.