| Theme |
Chronic Pancreatitis |
| Title |
Surgical Treatment for Chronic Pancreatitis |
| Author |
Akihiro Tanemura |
Hepatobiliary Pancreatic and Transplant Surgery, Faculty of Medicine, Mie University |
| Author |
Yu Nobuoka |
Hepatobiliary Pancreatic and Transplant Surgery, Faculty of Medicine, Mie University |
| Author |
Shuji Isaji |
Hepatobiliary Pancreatic and Transplant Surgery, Faculty of Medicine, Mie University |
| [ Summary ] |
According to the Japanese guidelines for chronic pancreatitis, failure of endoscopic treatment is an indication for surgical treatment. However, long-term pain relief is rarely achieved with endoscopic treatment alone. Therefore, surgical treatment is indicated without delay in the cases which are difficult to treat endoscopically. Furthermore, the possibility of pancreatic cancer and complications related to adjacent organs such as the bile duct or duodenal stenosis are absolute indications for surgical treatment. Operative procedures for chronic pancreatitis are classified to the three types：pancreatectomies, pancreatic ductal drainage, and ductal drainage with partial resection of pancreatic head lesions (hybrid operations) such as the Frey procedure and the Beger procedure. Hybrid operations are superior to pancreatectomies in terms of pain relief and safety. Therefore, they should be the first choice for surgical treatment. In comparison, the Frey and Beger procedures, are equally effective for pain control. However, the Frey procedure can be performed more easily and safely than the Beger procedure. |