Chronic pancreatitis: types of surgical intervention

Here we present the results of surgical treatment of 183 patients with chronic pancreatitis. The following surgical interventions were carried out: Longitudinal pancreatico-jejunal anastomosis on isolated Roux loop was performed in 12 patients, longitudinal pancreatico-jejunal and choledoco-jejunal anastomoses in 6 patients, cysto-jejunal anastomosis in 29 patients, cystogastroanastomosis in 5 patients, cystoentero-, choiedoco-entero- and gastroenteroanastomosis in 5 patients, pancreatic fistula removal in 2 patients, fistulo-jejunal anastomosis in 2 patients, fistula isolation and removal up to the pancreas forming a longitudinal pancreatico-jejunal anastomosis in 6 patients, and proximal resection of the pancreas in 7 patients. 109 patients also underwent proximal pancreatic resection: Classical pancreaticoduodenal resection was performed in 86 patients, pylorus-preserving version of pancreaticoduodenal resection in 16 patients, and pancreatic head resection in 7 patients. Overall post-operative lethality amounted in 5.46%, while lethality after pancreaticoduodenal resection was 8.8%. Remote results were studied 2 to 14 years after operation, revealing that surgical tactics of chronic pancreatitis treatment remain versatile. The type of surgery is determined by the form of chronic pancreatitis. Stabilization after operations on the pancreas largely depends on the appropriate timing of the operation.