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Duodenum‐Preserving resection of the head of the pancreas with denervation of the body and tail of the pancreas in patients with severe chronic pancreatitis
Author(s) -
Ikenaga Haruchika,
Katoh Hiroyuki,
Motohara Toshiji,
Takahashi Toshiyuki,
Doke Mitsuru,
Okushiba Shunichi
Publication year - 1995
Publication title -
journal of hepato‐biliary‐pancreatic surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.63
H-Index - 60
eISSN - 1868-6982
pISSN - 0944-1166
DOI - 10.1007/bf02348283
Subject(s) - medicine , pancreas , duodenum , pancreatitis , denervation , endocrine system , surgery , pancreatectomy , dissection (medical) , hormone
Abstract Duodenum‐preserving resection of the head of the pancreas with denervation of the body and tail of the pancreas was performed in 41 patients with severe chronic pancreatitis. The major advantage of this procedure is that only the small head of the pancreas is resected, leaving the endocrine and exocrine systems functioning normally, along with the pancreas, duodenum, and bile duct. This procedure provides complete pain relief. Ninety‐two percent of the patients experienced complete alleviation of pain and no recurrent pain due to postoperative pancreatitis; 76% of the patients were able to work well postoperatively, and 87% maintained their preoperative body weight. Postoperative glucose tolerance with a normal or glucose tolerance impairment pattern remained unchanged in 67% of the patients, with deterioration occurring in 33% of the patients between 3 months and 3 years postoperatively. However, 21% of the patients with a diabetic pattern preoperatively changed to a glucose tolerance impairment pattern between 3 months and 3 years postoperatively. Our procedure, which includes the dissection of the nerve plexus on the remnant pancreas and a near total resection of the head of the pancreas, allows the patient to maintain a good nutritional state as well as allowing for good endocrine function of the pancreas.