Surgical treatment of chronic pancreatitis--report of 227 cases.

In our series, long pancreaticojejunostomy appears to be the most effective treatment of chronic pancreatitis in the alcoholic, with 87% good to fair results, and with 90% good results in the non-alcoholic. The Whipple operation is the second most effective treatment for alcoholics with 45% good results, as opposed to 100% in non-alcoholics. Less than 40% good and fair results were achieved for alcoholics with 80-95% resection, sphincteroplasty, 40-80% resection, and total pancreatectomy. These operations were much more effective in non-alcoholics. The main differences between patients seen in Japan and in the United States seems to be a much lower incidence of alcohol-induced pancreatitis in the Japanese. Our findings in cases of congenital and non-alcoholic pancreatitis are similar to those reported in the case of chronic pancreatitis among Japanese, except that biliary trace procedures such as sphincteroplasty seem to have been more effective for the Japanese patients.