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SHORT- AND LONG-TERM RESULTS OF SURGICAL TREATMENT FOR CHRONIC PANCREATITIS: A SINGLE-CENTER RETROSPECTIVE EXPERIENCE IN JAPAN
Ippei Matsumoto*, Takaaki Murase, Keiko Kamei, Kohei Kawaguchi, Masataka Matsumoto, Shumpei Satoi, Takuya Nakai, Yoshifumi Takeyama
Surgery, Kindai University Faculty of Medicine, Osaka-Sayama, Osaka, Japan
Purpose:
The purpose of this study is to determine the short- and long-term results of surgical treatment for chronic pancreatitis at a high-volume center in Japan.
Methods:
The records of consecutive 151 patients were retrospectively reviewed. All patients underwent surgery at our institution for chronic pancreatitis between January 2005 and November 2016. Long-term (>1 year) follow-up was performed in 100 patients for median period of 19 months.
Results:
The patients consisted of 126 men (83%) and 25 women (17%) with a mean age of 53 years. The etiology of chronic pancreatic was alcoholic in 104 patients (69%). The major indication for surgery was acute pancreatic exacerbation (85%). Surgical procedures included in pancreatic resection in 37 (pancreas head resection in 11, distal pancreatectomy in 26), drainage procedure in 107 (Frey operation in 81, lateral pancreaticojejunostomy in 26), and other procedures in 6. Postoperative mortality rate was 0.7% (1/151). Postoperative morbidity defined by Clavien-Dindo classification II or more occurred in 40 patients (26%), including pancreatic fistula in 4 (3%, ISGPF grade B), and hemorrhage in 4 (3%). Long-term complete relief was achieved in 58 of 93 (62%) patients and partial pain relief in 34 (37%) patients. Twelve patients (8%) required subsequent surgery for pancreatitis related complications. Twenty one (21%) patients developed new-onset diabetes mellitus and 16 (16%) patients developed pancreatic exocrine insufficiently after surgery during long-term follow-up period.
Conclusion:
Surgical treatment for painful chronic pancreatitis may be safe and effective. It is important for the choice of operative procedure to understand the pathological condition of the particular individual case.
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