The Pylorus-Preserving Whipple Procedure for Severe Complications of Chronic Pancreatitis

1993 ◽  
pp. 396-413 ◽  
Author(s):  
L. W. Traverso
Keyword(s):  
Chronic Pancreatitis ◽  
Whipple Procedure

A Modern Review of the Operative Management of Chronic Pancreatitis

2010 ◽  
Vol 76 (10) ◽  
pp. 1071-1074 ◽  
Author(s):  
Jonathan C. King ◽  
Shannon Abeywardina ◽  
James J. Farrell ◽  
Howard A. Reber ◽  
O. Joe Hines
Keyword(s):  
Quality Of Life ◽  
Chronic Pancreatitis ◽  
Short Form ◽  
Operative Management ◽  
Poor Quality ◽  
Whipple Procedure ◽  
Life Questionnaire ◽  
Historical Controls

Chronic pancreatitis is a debilitating disease resulting in pain, intestinal malabsorption, endocrine dysfunction, and poor quality of life (QoL). Our aim was to analyze surgical outcomes for patients with chronic pancreatitis. Data for patients undergoing operations for chronic pancreatitis between 1990 and 2009 were reviewed. Demographics, operative and perioperative data, and survival were catalogued. QoL was determined (Short Form 36 and European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire + PAN-26) and compared with historical controls. The mean age was 51 ± 2 years, 38 patients were male (53%), the most common indication was pain (71%), the etiology of pancreatitis often was alcohol, and most patients underwent a Whipple procedure (56%). Operative time was 316 ± 17 minutes and blood loss was 363 ± 75 mL. There were 34 complications in 30 patients (42%) and one death. QoL surveys were administered for 25 of 55 (45%) surviving patients at a mean follow-up of 72 ± 16 months. Mean survival was 99 ± 9 months, whereas 5- and 10-year survival were 86 and 75 per cent. QoL scores were uniformly better than historical controls. Our data demonstrate that operations for chronic pancreatitis can be performed with acceptable morbidity and mortality. Patients have excellent survival and improved QoL compared with historical controls. Surgery is an effective and durable treatment option for patients with chronic pancreatitis.

Quality of life in chronic pancreatitis: A prospective, controlled trial comparing classical Kausch-Whipple procedure and duodenum-preserving head resection

2001 ◽  
Vol 120 (5) ◽  
pp. A53
Author(s):  
Helmut Witzigmann ◽  
Doris Max ◽  
Dirk Uhlmann ◽  
Felix Geissler ◽  
Reiner Schwarz ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Chronic Pancreatitis ◽  
Controlled Trial ◽  
Whipple Procedure

Whipple Procedure for Chronic Pancreatitis in a Jehovah's Witness

2007 ◽  
Vol 73 (9) ◽  
pp. 935-936 ◽  
Author(s):  
Hugo Bonatti ◽  
Marjory Dougerty ◽  
Kirk Martin ◽  
Ronald A. Hinder ◽  
Justin H. Nguyen ◽  
...  
Keyword(s):  
Chronic Pancreatitis ◽  
Whipple Procedure ◽  
Jehovah’S Witness ◽  
Jehovah's Witness

Acute and Chronic Pancreatitis

2020 ◽  
Author(s):  
Thomas J. Howard
Keyword(s):  
Acute Pancreatitis ◽  
Chronic Pancreatitis ◽  
Physical Examination ◽  
Clinical Evaluation ◽  
Gallbladder Disease ◽  
Scoring Systems ◽  
Whipple Procedure ◽  
General Surgeon ◽  
Enhanced Computed Tomography ◽  
Acute And Chronic Pancreatitis

Clinical evaluation and surgical decision making in patients with acute pancreatitis (AP) and chronic pancreatitis (CP) are two of the most complex conditions that a general surgeon faces. Each entity has unique laboratory and radiographic investigations, operations, and postoperative care. The clinical evaluation, history, and physical examination of AP is described. The clinical features necessary for diagnosis are listed, and contrast-enhanced computed tomography is described as the gold standard for diagnosis. This review uses definitions and terminology developed at the Atlanta symposium in 1992. The severity of an episode of AP is described in terms of established scoring systems (APACHE II [Acute Physiology and Chronic Health Evaluation II], Glasgow Coma Scale score, Ranson criteria). AP can range from mild to severe necrotizing, with each described. The clinical course is described in detail. For CP, the history, physical examination, and diagnosis via investigative and imaging studies are described. The anatomic and morphologic subtypes of chronic pancreatitis are listed and the operations directed at patients with CP are detailed, and can involve drainage or combined resection and drainage.  This review contains 12 figures, 14 tables, and 48 references. Keywords: Acute pancreatitis, chronic pancreatitis, gallbladder disease, alcoholism, amylase, Whipple procedure

The Pylorus Preserving Whipple Procedure for the Treatment of Chronic Pancreatitis

Swiss Surgery ◽  
2000 ◽  
Vol 6 (5) ◽  
pp. 259-263 ◽  
Author(s):  
Traverso
Keyword(s):  
Abdominal Pain ◽  
Chronic Pancreatitis ◽  
Pancreatic Head ◽  
Symptomatic Patient ◽  
Whipple Procedure ◽  
Long Term Outcomes ◽  
Long Term Follow Up ◽  
New Procedures

A schema is developed that outlines criteria to consider more than medical therapy for patients with severe pancreatitis that develop disabling abdominal pain. If the symptomatic patient has severe chronic pancreatitis that reaches the Cambridge Class V "marked" stage of image severity then endotherapy is indicated. If endotherapy fails then surgery is indicated. Usually these patients will have pathological changes centered in the pancreatic head and PPW is performed. After an average follow-up of > 4 years PPW was observed to provide either good to excellent relief of disabling abdominal pain. These patients were highly selected by the guidance of the anatomic profile of the composite pancreas. Long-term follow-up has never been available with cancer patients after the Whipple procedure. These chronic pancreatitis patients after PPW showed few GI side effects. In addition we did not observe a predisposition for diabetes other than that from the continued parenchymal destruction from smoldering chronic pancreatitis in the pancreatic remnant. Surgeons should avoid total pancreatectomy in patients, even if the patient is already diabetic. Marginal ulceration is highly associated with the total resection. From this personal experience using anatomic criteria and close follow-up, it is hoped that the long term outcomes of pain relief in virtually all patients after PPW will represent a benchmark for results after procedures which employ less resection. Therapy should be based on reliable imaging criteria to select patients. Then the outcomes of new and promising procedures such as lithotripsy or limited head resections can be compared to the benchmarks derived after PPW. None of the new procedures, however address the main problem after PPW of remnant pancreatitis in the pancreatic body/tail. Even though this discomfort is no longer disabling after head resection remnant pancreatitis does occur in approximately one out of four patients.

Sign in / Sign up

Export Citation Format

Share Document