Department of Surgery, University of Ulsan College of Medicine and Asan Medical Center
ABSTRACT
Chronic pancreatitis is not primarily a surgical disease. However, surgical intervention is required more often than acute pancreatitis. The principal indications for operation in chronic pancreatitis are intractable abdominal pain not amenable to medical treatment, complicated chronic pancreatitis such as bile duct obstruction, duodenal obstruction, large pseudocyst, pancreatic ascites, hemorrhage and venous compression, and suspicion of pancreatic cancer. Preoperative assessment of patient’s condition and definement of symptoms related to pancreatitis are important as well as correction of alcohol or drug addition. In order to be a proper treatment in chronic pancreatitis, cooperative team approach among gastroenterologist, endocrinologist, radiologist, and surgeon can not be overemphasized. Final operative procedure will be selected by the experienced surgeon under the full understanding of patient’s condition. Resective procedure on chronic pancreatitis sometimes can be a more difficult one than cancer, due to severe peripancreatic fibrotic reaction. Save the some indications for total pancreatectomy which cause inevitable endocrine and exocrine insufficiency, partial pancreatectomy, namely pancreatoduodenectomy can be used under the condition of lower postoperative morbidity and mortality. Again operative treatment can be a final treatment modality in chronic pancreatitis under the consensus of many specialists on pancreatic disease and full understanding about the operation from the patient and relatives.
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