Observations and surgical management of tropical pancreatitis in Kerala and southern India.

This article describes the surgery of tropical pancreatitis as practiced in a region of high incidence, based on the experience at 2 centers: the Department of Surgical Gastroenterology and Proctology, Government General Hospital, Madras, Tamilnadu (a tertiary-care referral unit) where 52 patients were diagnosed and 40 were operated on between 1982 and 1987; and the Department of Gastroenterology, Deva Matha Hospital, Koothattukulam (a specialized center located in the main endemic area of Kerala), where 116 patients were diagnosed and 33 operated on between 1983 and 1988. The latter series is described in detail with emphasis on the preoperative imaging, operative findings, surgical procedures, complications, and results of surgery. The experience of other centers in southern India is summarized and discussed. The disease is obviously different from chronic pancreatitis in the West. Special problems of tropical pancreatitis, particularly the management of diabetes and the association of pancreatic carcinoma at a young age, are discussed.