Rationality of surgical managements according to the pathological anatomy of chronic pancreatitis        GAO Hong-qiao, CAI Meng-shan, MA Yong-su, et al. Department of General Surgery, Peking University First Hospital, Beijing 100034, China
Corresponding author: YANG Yin-mo, E-mail: yangyinmo@263.net
Abstract    Objective    To investigate the outcome after surgery directed by pathological anatomy of chronic pancreatitis and provide evidence for surgical procedures. Methods    The clinical material of 60 patients with chronic pancreatitis who underwent surgical treatment between 2000 and 2010 were investigated retrospectively. Result    43 cases (71.7%)  presented with abdominal pain, Perioperative mortality was 1.7% (1 case). Forty-two patients with abdominal pain were all relieved after surgery, but long-term recurrence occered in 17 cases  (40.5%). Modified Puestow procedure was performed on 21 patients with dilatation of pancreatic duct and/or lithiasis,  long-term pain recurrence occered in 8 cases (38.1%);  Six patients undergoing pancreatic head resection had no recurrence in the long-term follow-up; Pain recurrence rate of 11 cases with only cholangioenterostomy was 81.2% (9 cases) within 2 years. Chronic pancreatitis with common bile duct obstruction occurred in 33 cases(55%), cholangioenterostomy alone or combined with partly pancreatic resection or pancreatic duct drainage procedures could alleviate symptoms of biliary obstruction, 4(33.3%) cases after pure biliary drainage emerged abdominal pain, 5 cases of pancreatic head resection had no recurrence of jaundice and abdominal pain after long-term follow-up. Conclusion    Surgical procedures should be selected according to the pathological anatomy of chronic pancreatitis. Reasonable pancreatic head resection and adequate bile and/or pancreatic drainage could significantly improve the long-term outcomes.