Pancreas, Chronic Pancreatitis and Surgery

Overview

The authors present the most important historical data on the function of the pancreas and data on the development of basic surgical operations. They outline indications for surgery and the most widely used surgical operations used in recent years incl. evaluation of experience with duodenum sparing operations at the First Surgical Clinic, First Medical Faculty Charles University and General Faculty Hospital in Prague. The state critically that there is no single recommendable operation for this disease and the pathological picture can also vary. In the conclusion they mention their own experience assembled during the last six years where of 170 operated patients a duodenum sparing operation in some modification could be performed only establishment of an anastomosis between the pancreatic duct and the eliminated jejunal loop (Partington-Rochelle) in 37 patients, and in case of major portal hypertension in 16 patients they had to be satisfied only with a biliodigestive anastomosis with the eliminated intestinal loop. The uncertainty whether a malignant tumour is involved made the surgen use 18 times Whipple’s resection. One patient died from sepsis during decompensation of diabetes. As regards improvement, regression of pain and integration into life the position was most favourable after Beger’s operation.

Key words:
chronic pancreatitis - pancreatitis chronica - historical review - indications for surgery - surgery - therapeutic results