Phillip J, Schmid A
Fortschr Med. 1977 Aug 11;95(30):1875-9.
Because of the differently selected groups of patients due to a narrow indication for pancreatic surgery, a direct comparison of the results of conservative and surgical therapy is not possible. A follow-up survey of 348 patients with proven chronic pancreatitis showed that patients suffering from uncomplicated pancreatitis should be treated conservatively as long as possible, for 70% (77 out of 109) will improve. In 2/3 of our patients with chronic pancreatitis, surgical treatment became necessary. As to the recurrence of pancreatitis and the lethality, resecting techniques were more successful (72%: 107 out of 148) than the non-resecting ones (61%: out of 91). The cooperation of the patient is crucial for the prognostic outcome regardless of the kind of treatment; especially the elimination of alcohol intake is essential. The most important accompanying or/and succeeding disease is diabetes mellitus, which impairs the long term prognosis especially because of the hazard of postoperative irreversible hypoglycemia. Optimal treatment of patients with chronic pancreatitis can only be accomplished on an individual basis and on the basis of a close cooperation of internists and surgeons.
由于胰腺手术适应症狭窄导致患者分组不同，无法对保守治疗和手术治疗的结果进行直接比较。对348例确诊为慢性胰腺炎的患者进行的随访调查显示，患有非复杂性胰腺炎的患者应尽可能长时间接受保守治疗，因为70%（109例中的77例）病情会改善。在我们2/3的慢性胰腺炎患者中，有必要进行手术治疗。至于胰腺炎的复发率和死亡率，切除技术（72%：148例中的107例）比非切除技术（61%：91例中的……）更成功。无论采用何种治疗方式，患者的配合对预后结果都至关重要；尤其是戒酒至关重要。最重要的伴随或/及后续疾病是糖尿病，它会损害长期预后，特别是因为术后有不可逆低血糖的风险。慢性胰腺炎患者的最佳治疗只能在个体化基础上，并在内科医生和外科医生密切合作的基础上完成。 （注：原文中“61%: out of 91”表述似乎不完整）
