[The Whipple partial duodenopancreatectomy--its value in the treatment of chronic pancreatitis]. / Die partielle Duodenopankreatektomie nach Whipple--Stellenwert in der Behandlung der chronischen Pankreatitis.

ABSTRACT

The surgical treatment of chronic pancreatitis is indicated only in the complicated disease. The aim is mainly the treatment of pain, of mechanical obstacles and to exclude suspicion of cancer. Between October 1972 and January 1993 713 patients with chronic pancreatitis were treated at the Surgical University Hospital in Mannheim. In 40% of the patients conservative treatment was continued or intensified. Only in 123 patients a Whipple operation was performed. The leading symptom was pain in these patients. We saw postoperative surgical complications in 14 patients (11.4%). One of them died due to an operative leak (0.8%). Late results are based on a median follow up of 4.8 years and showed a complete or substantial pain relief in 94%. 66% went back to work. 77% gained weight with an average of more than 10 kg. The rate of postoperative endocrine insufficiency was 10% (total 40%), of exocrine insufficiency 26 (total 51%). Late mortality was 11% and mostly caused by continued alcoholic abuse. Based on these results, the Whipple operation seems to be the best standardized method for surgery of the complicated chronic pancreatitis within the head of the pancreas.