Surgical management of chronic pancreatitis at the Mayo clinic

G. H. Sakorafas, M. B. Farnell, D. M. Nagorney, M. G. Sarr

Research output: Contribution to journalArticle

18 Scopus citations

Abstract

The authors' approach to the overall surgical management of chronic pancreatitis is to treat complications, that is, pain and, less commonly, obstruction and bleeding. The authors' practice is to exhaust nearly all forms of nonsurgical intervention before suggesting a surgical approach. Nonresponders are then evaluated for severity of pain, interference of quality of life, and presence of chemical dependency. Appropriate candidates undergo imaging examinations to determine the primary site of disease, presence of pancreatic ductal dilatation, and associated peripancreatic complications. The surgical treatment approach involves classic lines of proximal resection (pylorus-preserving pancreaticoduodenectomy) for small duct disease and lateral pancreaticojejunal drainage for a dilated pancreatic duct. The authors have not yet routinely adopted the duodenum-preserving head resections of Beger and Frey, or thoracoscopic transthoracic splanchnicectomy, but they remain open-minded and avidly await good confirmatory, independent trials of these promising surgical interventions.

Original languageEnglish (US)
Pages (from-to)457-465
Number of pages9
JournalSurgical Clinics of North America
Volume81
Issue number2
DOIs
StatePublished - Jan 1 2001

ASJC Scopus subject areas

  • Surgery

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