Evaluation of the surgical treatment of chronic calcifying pancreatitis. 1985

C E Nogueira, and R Dani

In the last 20 years, we have observed 264 instances of CCP. Of these, 136 (50.5 per cent) had 171 surgical procedures. Pancreatic calcifications were present in 83.1 per cent of the patients. One hundred and twenty-one were alcoholics (88.9 per cent) and 15 (11.0 per cent) abstained from alcohol. The surgical indications involved clinical uncontrollable pain and organic complications of the disease. The operations performed consisted of 62 wide side to side pancreaticojejunostomies, with loop excluded in Roux-en-Y, 40 pancreatectomies and 69 other operations. The choice of operation depended upon the analysis of each patient. The postoperative period of observation varied from two to 198 months, the average being 56.9 +/- 49.1 months. Thirty-five reoperations were performed for persistence or relapse of pain or the appearance of complications. Immediate post-operative complications and deaths occurred in 44 (25.7 per cent) and in six patients (3.5 per cent), respectively, considering the 71 operations performed. A satisfactory pain relief was evidenced in 61.0 per cent of the patients and total mortality reached 42.6 per cent. When the patients who underwent pancreaticojejunostomy, pancreatectomy and other operations were compared, no significant statistical difference was noticed with regard to the incidence of immediate post-operative complications and deaths, pain relief, appearance of diabetes or steatorrhea and mortality. There was also no significant difference as to the mortality among the alcoholic CCP, calcified or not, and idiopathic CCP (all calcified). On the other hand, the difference was statistically significant concerning the reoperation incidence in the group of patients who underwent the three types of operations mentioned. The longest survival time after pancreaticojejunostomy, pancreatectomy and other operations was 192, 137 and 198 months, respectively. The mean age at the time of death was 44.5 +/- 10.0 years, significantly inferior to the life expectation of the Brazilian male, which is 62 years. The mortality was higher in the first five postoperative years, corresponding to 77.6 per cent of the over-all mortality. There was no significant difference of survival time among the groups of patients undergoing the different types of operations. CCP is an extremely serious disease, progressive in spite of adequate treatment, sensibly diminishing the expectation and quality of lives of those with the condition, often interfering with the activity and productivity of the patient.(ABSTRACT TRUNCATED AT 400 WORDS)

UI MeSH Term Description Entries
D007583 Jejunum The middle portion of the SMALL INTESTINE, between DUODENUM and ILEUM. It represents about 2/5 of the remaining portion of the small intestine below duodenum. Jejunums
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D010146 Pain An unpleasant sensation induced by noxious stimuli which are detected by NERVE ENDINGS of NOCICEPTIVE NEURONS. Suffering, Physical,Ache,Pain, Burning,Pain, Crushing,Pain, Migratory,Pain, Radiating,Pain, Splitting,Aches,Burning Pain,Burning Pains,Crushing Pain,Crushing Pains,Migratory Pain,Migratory Pains,Pains, Burning,Pains, Crushing,Pains, Migratory,Pains, Radiating,Pains, Splitting,Physical Suffering,Physical Sufferings,Radiating Pain,Radiating Pains,Splitting Pain,Splitting Pains,Sufferings, Physical
D010179 Pancreas A nodular organ in the ABDOMEN that contains a mixture of ENDOCRINE GLANDS and EXOCRINE GLANDS. The small endocrine portion consists of the ISLETS OF LANGERHANS secreting a number of hormones into the blood stream. The large exocrine portion (EXOCRINE PANCREAS) is a compound acinar gland that secretes several digestive enzymes into the pancreatic ductal system that empties into the DUODENUM.
D010180 Pancreatectomy Surgical removal of the pancreas. (Dorland, 28th ed) Pancreatectomies
D010195 Pancreatitis INFLAMMATION of the PANCREAS. Pancreatitis is classified as acute unless there are computed tomographic or endoscopic retrograde cholangiopancreatographic findings of CHRONIC PANCREATITIS (International Symposium on Acute Pancreatitis, Atlanta, 1992). The two most common forms of acute pancreatitis are ALCOHOLIC PANCREATITIS and gallstone pancreatitis. Acute Edematous Pancreatitis,Acute Pancreatitis,Pancreatic Parenchyma with Edema,Pancreatic Parenchymal Edema,Pancreatitis, Acute,Pancreatitis, Acute Edematous,Peripancreatic Fat Necrosis,Acute Edematous Pancreatitides,Acute Pancreatitides,Edema, Pancreatic Parenchymal,Edematous Pancreatitides, Acute,Edematous Pancreatitis, Acute,Fat Necrosis, Peripancreatic,Necrosis, Peripancreatic Fat,Pancreatic Parenchymal Edemas,Pancreatitides, Acute,Pancreatitides, Acute Edematous,Parenchymal Edema, Pancreatic,Peripancreatic Fat Necroses
D011183 Postoperative Complications Pathologic processes that affect patients after a surgical procedure. They may or may not be related to the disease for which the surgery was done, and they may or may not be direct results of the surgery. Complication, Postoperative,Complications, Postoperative,Postoperative Complication
D012086 Reoperation A repeat operation for the same condition in the same patient due to disease progression or recurrence, or as followup to failed previous surgery. Revision, Joint,Revision, Surgical,Surgery, Repeat,Surgical Revision,Repeat Surgery,Revision Surgery,Joint Revision,Revision Surgeries,Surgery, Revision
D001938 Brazil A country located on the eastern coast of South America, located between Colombia and Peru, that borders the Atlantic Ocean. It is bordered on the north by Venezuela, Guyana, Suriname, and French Guiana, on the south by Uruguay, and on the west by Argentina. The capital is Brasilia.

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