Pancreatic duct pressure in chronic pancreatitis.

The wide variety of surgical procedures available for the relief of pain in patients with chronic pancreatitis attests to a lack of understanding of the precise mechanisms responsible for the onset of pain in this condition. In the development of surgical procedures designed to "decompress" the pancreatic duct in chronic pancreatitis, it has been tacitly assumed that pancreatic duct hypertension exists and is important in the pathophysiology of the disease. In 19 patients with chronic pancreatitis and dilated pancreatic ducts, pancreatic duct pressure was significantly higher than in control patients. In view of the dramatic relief of preoperative pain after procedures for decompressing the pancreatic ducts, ductal hypertension has been confirmed as an important mechanism of pain production in this group of patients.