W T Knoefel1, S B Hosch, M Peiper. 1. Department of Surgery, University Hospital Duesseldorf, Duesseldorf, Germany. knoefel@uni-duesseldorf.de
Abstract
BACKGROUND: Chronic pancreatitis is a progressive disease which complications lead to increased morbidity and social and professional problems. MATERIAL AND METHODS: The authors analysed the current treatment options for chronic pancreatitis and compared it to the former treatment options. RESULTS: Historically surgical treatment options of chronic pancreatitis were associated with a high complication rate due to pancreatitic surgery. Furthermore, inadequate assessment of outcome lead to the treatment approach of watchful waiting and endoscopic interventions. Improving experiences with pancreatic surgery (high volume, combination of resection and drainage, e.g., duodenum-preserving pancreatic head resection) in some centers combined to modern evaluation methods revealed a low mortality (<5%), acceptable perioperative morbidity (15-20%), low reoperation rate (10%) and in 80% of the patients complete freedom of pain. CONCLUSION: A combination of drainage and resection tailored to the patient's need and performed early before developing endocrine insufficiency, seems to be the best medical care currently available to patients suffering from chronic pancreatitis.
BACKGROUND:Chronic pancreatitis is a progressive disease which complications lead to increased morbidity and social and professional problems. MATERIAL AND METHODS: The authors analysed the current treatment options for chronic pancreatitis and compared it to the former treatment options. RESULTS: Historically surgical treatment options of chronic pancreatitis were associated with a high complication rate due to pancreatitic surgery. Furthermore, inadequate assessment of outcome lead to the treatment approach of watchful waiting and endoscopic interventions. Improving experiences with pancreatic surgery (high volume, combination of resection and drainage, e.g., duodenum-preserving pancreatic head resection) in some centers combined to modern evaluation methods revealed a low mortality (<5%), acceptable perioperative morbidity (15-20%), low reoperation rate (10%) and in 80% of the patients complete freedom of pain. CONCLUSION: A combination of drainage and resection tailored to the patient's need and performed early before developing endocrine insufficiency, seems to be the best medical care currently available to patients suffering from chronic pancreatitis.
Authors: Gernot Köhler; Oliver Owen Koch; Stavros A Antoniou; Franz Mayer; Michael Lechner; Leo Pallwein-Prettner; Klaus Emmanuel Journal: World J Surg Date: 2014-09 Impact factor: 3.352