Surgical management of chronic calcified pancreatitis

Abstract

Background: Chronic pancreatitis is a progressive inflammation of the pancreas associated to fibrosis, pancreatic atrophy, calcifications, and chronic pain. Intractable pain is the main indication for surgical treatment. Surgical procedures are based in ductal decompression, ductal drainage, and resection. Aim: Analyze the surgical management of patients with symptomatic calcified chronic pancreatitis. Methods: From March 2009 and September 2019, 12 patients underwent surgical treatment due to chronic calcified pancreatitis. There were eleven male (91.7%) and one female (8.3%) and the mean age was 58.2 years (range 48–70 years). Regular alcohol ingestion was observed in all patients (100%). The main indication for surgery was pain control in ten patients (83.3%). Results: The procedures included Partington-Rochelle (6 patients, 50.0%), Frey procedure (3 patients, 25.0 %), pancreatoduodenectomy (2 patients, 16.6%) and total pancreatectomy (1 patient, 8.3%). Four patients (33.3%) had postoperative complications. No Clavien-Dindo ≥ 3b complications and no 90-days mortality were recorded in this series. Postoperative exocrine dysfunction was observed in 4 patients (33.3%), and all of them received pancreatic enzyme supplement. Conclusions: Surgical treatment is a safe and feasible choice with acceptable morbidity and no mortality for symptomatic patients with calcified chronic pancreatitis.

Keywords

• Chronic pancreatitis
• Resection
• Pancreatoduodenectomy
• Total pancreatectomy
• Frey procedure
• Pancreatic cancer