We reviewed the charts of 752 patients, who have undergone surgery
for various forms of chronic pancreatitis at “Shalimov’s National
Institute of Surgery and Transplantation of the NAMS of Ukraine” in
the years from 2007 to 2017. The average age of the 591 males (78,6
%) and 161 females (22,4 %) was 43,0 ± 3,2 years. Out of these, 446
(62,4 %) patients with pseudocysts and pancreatic fistula and also
with isolated main pancreatic duct lithiasis underwent drainage procedures. The 269 (37.6%) patients were subjected to different types of
resection, including the Frey operation, pancreatoenterostomy with
artificial pancreatic duct formation, the Berne technique, the Beger
procedure, pancreatoduodenectomy, distal-pancreatic resection and
other procedures. After pancreatic resections, the patients did not
require repeated surgical interventions for chronic pancreatitis.
In some cases of chronic pancreatitis, there was an isolated lesion of
the pancreas: in such cases (13 patients), we performed distal resection of the pancreas. Among the observed patients here were no fatal
cases. Satisfactory results were obtained in 92.6 % of cases at longterm follow-up. Post-operative complications occurred in 27 patients
(4.6 %), in 6 (1.03 %) patients there was a need for repeated surgery.
Progression of the disease in patients previously operated in our
clinic was observed in 32 (5.5 %), and 72 patients, initially operated
in other medical institutions. Patients after direct resection of the
pancreas did not require repeated surgery for chronic pancreatitis.
The main causes of unsatisfactory results of the surgical treatment
for chronic pancreatitis have been found to be: false indications for
initial surgery, improper primary surgical techniques, insufficient use
of drainage procedures, as well as, performing a drainage procedure
instead of a resection.
Key words: chronic pancreatitis, surgical treatment, resection and
drainage procedures.
For citation: Usenko OY, Kopchak VM, Nychytailo MY, Duvalko OV,
Khanenko VV, Trachuk VI, Khomiak AI. Modern principles of surgical
treatment of chronic pancreatitis. Journal of the National Academy of
Medical Sciences of Ukraine. 2019;25(3):306–12