Pancreatic Duct Drainage in Chronic Pancreatitis

Abstract

Chronic pancreatitis is a progressive inflammatory disease characterized by permanent morphologic and functional damage to the pancreas. The destruction of the pancreatic parenchyma that occurs with this disease may be surprisingly asymptomatic or may result in intractable abdominal pain, steatorrhea and/or diabetes mellitus. Chronic pancreatitis is not primarily a surgical disease, and it should be managed medically until a surgically correctable complication develops. Those complications that require surgical treatment include the development of pancreatic ascites, pancreatic fistula, fixed fibrotic obstruction of the intrapancreatic portion of the common bile duct or of the duodenum, hemorrhage secondary to splenic vein thrombosis, and inability to differentiate the disease from pancreatic cancer. However, most patients are referred to a surgeon because of unrelenting abdominal and/or back pain. In addition to being refractory to medical therapy, this incapacitating pain often leads to narcotic addiction.