Ammann R W, Largiadèr F, Akovbiantz A
Scand J Gastroenterol. 1979;14(2):209-15. doi: 10.3109/00365527909179872.
Since 1963, 57 consecutive patients with chronic pancreatitis, 44 of them alcoholics who had been operated upon for recurrent severe pain, have been controlled regularly for an average of 6 years. Thirty-two of them had a cyst drainage procedure (group A), and 25 had a ductal drainage procedure and/or distal pancreatectomy (group B). Ten patients died within 2 years (group A, n = 5). Lasting pain relief by surgery occurred in 19 patients only. Of 28 patients with pain relapses after surgery (group A, n = 15), however, 22 (78.6%) obtained late pain relief 1-8 years after surgery in association with marked increase of pancreatic dysfunction (group A, n = 12). Pain relief was associated with pancreatic calcifications in 71-86% of the alcoholics. Cyst drainage procedures were successful in preventing pain relapses mainly in patients with either advanced pancreatic dysfunction or in non-alcoholic pancreatitis. The data suggest that in chronic pancreatitis lasting pain relief is more often due to marked pancreatic dysfunction than to surgery. Alcohol abstinence after surgery was probably an additional factor for lasting pain relief in some patients.
自1963年以来，对57例连续性慢性胰腺炎患者进行了平均6年的定期随访，其中44例为因复发性剧痛接受手术治疗的酗酒者。他们当中32例行囊肿引流术（A组），25例行导管引流术和/或胰腺远端切除术（B组）。10例患者在2年内死亡（A组5例）。仅19例患者术后疼痛得到持久缓解。然而，在术后疼痛复发的28例患者中（A组15例），22例（78.6%）在术后1 - 8年出现晚期疼痛缓解，同时伴有胰腺功能明显恶化（A组12例）。71 - 86%的酗酒者疼痛缓解与胰腺钙化有关。囊肿引流术主要在胰腺功能严重受损或非酒精性胰腺炎患者中成功预防了疼痛复发。数据表明，在慢性胰腺炎中，持久的疼痛缓解更多是由于胰腺功能明显恶化而非手术。术后戒酒可能是部分患者疼痛持久缓解的另一个因素。
