[Pancreaticojejunostomy in the treatment of chronic pancreatitis]

Ann Chir. 2003 Nov;128(9):610-5. doi: 10.1016/j.anchir.2003.09.012.
[Article in French]

Abstract

Introduction: The aim of this retrospective study was to evaluate the immediate and long-term outcome of pancreaticojejunostomy (PJ) in the treatment of chronic pancreatitis. MATERIAL AND METHODS. - From 1980 to 1997, 140 patients with chronic pancreatitis with dilated Wirsung duct were treated by PJ and were studied retrospectively. There were 123 men and 17 women, with a mean age of 46 years (range: 18-79 years). Ongoing alcoholic addiction was present in 116 patients (83%). Chronic pain uncontrolled by major analgesics was the indication of PJ in 126 patients (90%).

Results: The mortality rate was 1.4% (n = 2). The morbidity rate was 11% (n = 16). Mean hospital stay was 16 days (range: 8-25 days). The mean follow-up was 7.4 years (range: 2-15 years) in 94 patients. Functional results were good or mild in 93% of cases (n = 87). In seven patients (7%), the results were bad with persistence of chronic pain requiring major analgesics. A mean weight increase of 5.8 kg (range: 1-16 kg) was observed in 74 patients (79%). Twelve patients (13%) developed de novo diabetes mellitus. In the 43 patients with preoperative diabetes, 24 patients suffered deterioration of their status. No patient recovered from exocrine insufficiency.

Conclusions: In case of dilated Wirsung, PJ must be indicated preferentially because of its good efficiency on pain relief with low mortality and morbidity rates.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Alcoholism / complications
  • Cholangiography
  • Chronic Disease
  • Diabetes Mellitus / etiology
  • Dilatation, Pathologic / complications
  • Dilatation, Pathologic / diagnostic imaging
  • Dilatation, Pathologic / mortality
  • Dilatation, Pathologic / surgery
  • Female
  • Humans
  • Length of Stay / statistics & numerical data
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Morbidity
  • Pain / etiology
  • Pancreatic Ducts / pathology
  • Pancreaticojejunostomy / adverse effects
  • Pancreaticojejunostomy / methods*
  • Pancreaticojejunostomy / mortality
  • Pancreatitis / complications
  • Pancreatitis / diagnostic imaging
  • Pancreatitis / mortality
  • Pancreatitis / surgery*
  • Patient Selection
  • Retrospective Studies
  • Tomography, X-Ray Computed
  • Treatment Outcome
  • Weight Gain