Ductal drainage for chronic pancreatitis.

The operative experience of 23 patients with chronic or chronic relapsing pancreatitis who underwent ductal drainage is reviewed. All of those studied were treated for pain directly related to their pancreatitis and had no evidence of pseudocyst. Each patient was followed up for a minimum of 5 years postoperatively. In those persons with a diffusely dilated duct or "chain of lakes" pattern seen on ERCP, ductal drainage was preferred to pancreatic resection because of lower mortality and preservation of endocrine function. Internal ductal drainage as described by Partington, Rochelle, and Thal was the procedure of choice because it provides excellent pain relief and splenectomy is not required. Good or excellent long-term pain relief was achieved in 90% of patients undergoing operative intervention. Ductal drainage was frequently complicated by peptic ulcer disease. Postoperative antacid or histamine blocker therapy is recommended.