Department of Surgery, Kindai University Faculty of Medicine, Osaka-sayama, Japan.
J Hepatobiliary Pancreat Sci. 2020 Sep;27(9):632-639. doi: 10.1002/jhbp.795. Epub 2020 Jul 30.
BACKGROUND/PURPOSE: To determine the short- and long-term results of surgical treatments for chronic pancreatitis (CP) at a high-volume center in Japan.
The records of 151 consecutive patients undergoing surgery for CP were retrospectively reviewed. Selection of surgical procedures used had been according to the Japanese Clinical Practice Guidelines for CP 2015. Long-term (≥1 year) follow-up was performed in 100 patients (median of 37 months).
Surgical drainage procedures were performed in 107 patients (Frey operation in 81, longitudinal pancreaticojejunostomy in 26), pancreatic resection in 37 (subtotal stomach-preserving pancreaticoduodenectomy in 11, distal pancreatectomy in 26), and other procedures in six. The rates of postoperative mortality and morbidity were 1% and 26%, respectively. The rates of complete and partial pain relief were 62% and 37%. The frequency of occurrence of severe morbidity was significantly higher after pancreatic resection than in patients receiving drainage procedures (13% vs 2%, P = .019). The rate of new-onset diabetes was also significantly higher after resection than drainage (60% vs 25%, P = .017).
Surgical treatment for painful chronic pancreatitis can be safe and effective. An optimal procedure should guarantee pain relief and preserve a maximum of pancreatic function.
背景/目的：在日本一家高容量中心确定慢性胰腺炎 (CP) 的手术治疗的短期和长期结果。
回顾性分析了 151 例连续接受 CP 手术治疗的患者的记录。手术程序的选择是根据 2015 年日本 CP 临床实践指南进行的。对 100 例患者（中位随访 37 个月）进行了长期（≥1 年）随访。
107 例患者行手术引流（81 例行 Frey 手术，26 例行纵向胰肠吻合术），37 例行胰腺切除术（11 例行保留胃的胰十二指肠切除术，26 例行胰体尾切除术），6 例行其他手术。术后死亡率和发病率分别为 1%和 26%。完全缓解和部分缓解的疼痛率分别为 62%和 37%。胰腺切除术后严重发病率的发生率明显高于引流组（13%比 2%，P=0.019）。手术后新发糖尿病的发生率也明显高于引流组（60%比 25%，P=0.017）。
手术治疗慢性胰腺炎疼痛是安全有效的。最佳手术方案应保证缓解疼痛并保留最大的胰腺功能。
