Advertisement

Duodenum-Preserving Total Pancreatectomy for Chronic Pancreatitis

  • R. C. G. Russell
Conference paper

Abstract

The role of surgery in the management of chronic pancreatitis is a subject of debate [1]. Most would agree that the place for surgery is clear when there is a complication of chronic pancreatitis which is amenable to surgical intervention. Unfortunately, the problem often facing the clinician is that of a patient with chronic pain, on an increasing dose and strength of analgesia, and whose quality of life is destroyed by the effects of both pain and analgesia. There is a group of patients who fail to respond to, or who relapse after, non-surgical procedures such as nerve blocks and endoscopic sphincterotomies; of these there are some whose symptoms are not relieved by pancreatic drainage procedures or partial pancreatectomies. In the patient with intractable pancreatic pain the lesser operative procedures have usually been tried but have failed. This type of patient is usually on high doses of a narcotic analgesic, but still incapacitated by unremitting pain; for such patients there is little to offer other than total pancreatectomy.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Sato T, Miyashita E, Matsuno S, Yamauchi H (1986) The role of surgical treatment for chronic pancreatitis. Ann Surg 203: 266–271PubMedCrossRefGoogle Scholar
  2. 2.
    Whipple AO (1946) Radical surgery for certain cases of pancreatic fibrosis associated with calcareous deposits. Ann Surg 124: 991–1006CrossRefGoogle Scholar
  3. 3.
    Warren KW (1969) Surgical management of chronic relapsing pancreatitis. Am J Surg 117: 24–32PubMedCrossRefGoogle Scholar
  4. 4.
    Traverso LW, Longmire WP (1978) Preservation of the pylorus in pancreaticoduodenectomy. Surg Gynaecol Obstet 146: 959–962Google Scholar
  5. 5.
    Traverso LW, Longmire WP (1980) Preservation of the pylorus in pancreatoduodenectomy — a follow-up evaluation. Ann Surg 192: 306–309PubMedCrossRefGoogle Scholar
  6. 6.
    Traverso LW, Tompkins RK, Urrea PT, Longmire WP (1979) Surgical treatment of chronic pancreatitis. Ann Surg 190: 312–316PubMedCrossRefGoogle Scholar
  7. 7.
    Newman KD, Braasch JW, Rossi RL, Campo-Gonzales S (1983) Pyloric and gastric preservation with pancreatoduodenectomy. Am J Surg 145: 152–156PubMedCrossRefGoogle Scholar
  8. 8.
    Beger HG, Krautzberger W, Bittner R, Büchler M, Limmer J (1985) Duodenum-preserving resection of the head of the pancreas in patients with severe pancreatitis. Surgery 97: 467–473PubMedGoogle Scholar
  9. 9.
    Eloy R, Bouchet P, Clendinnen G, Daniel J, Grenier JF (1980) New technique of total pancreatectomy without duodenectomy in the dog. Am J Surg 140: 409–412PubMedCrossRefGoogle Scholar
  10. 10.
    Harken AH, Filler RM, Auruskin TW, Crigler JF (1971) The role of total pancreatectomy in the treatment of unremitting hypoglycaemia of infancy. J Pediatr Surg 6: 284–289PubMedCrossRefGoogle Scholar
  11. 11.
    Gough MH (1984) The surgical treatment of hyperinsulinism in infancy and childhood. Br J Surg 71: 75–78PubMedCrossRefGoogle Scholar
  12. 12.
    Murphy JP, Russel RCG (1988) Operative treatment of nesidioblastosis. Br J Surg 75: 930Google Scholar
  13. 13.
    Thomas DM, Langford RM, Russell RCG, Le Quesne LP (1978) The anatomical basis for gastric mobilisation in total oesophagectomy. Br J Surg 65: 356–360Google Scholar
  14. 14.
    Lambert MA, Linehan IP, Russell RCG (1987) Duodenum-preserving total pancreatectomy for end stage chronic pancreatitis. Br J Surg 74: 35–39PubMedCrossRefGoogle Scholar
  15. 15.
    Linehan IP, Lambert MA, Brown DC, Kurtz AB, Cotton PB, Russell RCG (1988) Total pancreatectomy for chronic pancreatitis. Gut 29: 358–365PubMedCrossRefGoogle Scholar
  16. 16.
    Linehan IP, Russel RCG, Hobsley M (1988) The dumping syndrome after pancreatoduodenectomy. Surg Gynaecol Obstet 167: 114–118Google Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1990

Authors and Affiliations

  • R. C. G. Russell
    • 1
  1. 1.The Middlesex HospitalLondonUK

Personalised recommendations