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Organ-Preserving Pancreatic Head Resection Effective For Short Term Relief Of Inflammation In Chronic Pancreatitis

Duodenum-preserving pancreatic head resection is safe and provides short-term relief of symptoms associated with inflammatory enlargement of the pancreatic head in patients with chronic pancreatitis.

Inflammation of the pancreatic head occurs in 20 to 30% of patients with chronic pancreatitis, explain researchers from the Department of Surgery at the University of Szeged in Szeged, Hungary.

The researchers evaluated a duodenum-preserving pancreatic head resection procedure in 27 men and three women aged a mean 44 years. Weight loss with frequent abdominal pain was present in all of the patients. Three had jaundice and 10 had diabetes mellitus.

Endoscopic retrograde cholangiopancreatography, sonography and computed tomography were used to diagnosis chronic pancreatitis. Amylum tolerance tests, oral glucose tolerance tests and stool elastase measurements were used to assess pancreatic function.

Wide local resection of the inflammatory tumour in the pancreatic head was performed without dividing the pancreas over the portal vein. Drainage via a jejunal Roux-en-Y loop was used during reconstruction. Prepapillary bile duct anastomosis was also performed in three icteric cases using the same type of loop.

No hospital deaths or major complications occurred. All patients were symptom free after a median follow-up of ten months. Patients showed a mean increase in body-weight of 8.9 kilograms.

Exocrine function improved as demonstrated by amylum tolerance tests and stool elastase levels, however, here was no change in endocrine function.
Br J Surg 2003;90(1):29-32. "Organ-preserving pancreatic head resection in chronic pancreatitis."

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