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SURGERY FOR CHRONIC PANCREATITIS: EXPERIENCE AND TRENDS IN AUCKLAND
Author(s) -
Windsor J. A.,
Veersingam P.,
Quistorff D.
Publication year - 2007
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/j.1445-2197.2007.04122_15.x
Subject(s) - medicine , pancreatitis , audit , surgery , pancreatic cancer , complication , clinical trial , general surgery , cancer , management , economics
Purpose There has been uncertainty, if not skepticism, about the role of surgery for chronic pancreatitis (CP) in New Zealand. The aim of the study was to review the indications, operations and outcomes for this type of surgery. Methodology All patients with CP managed by the HBP/Upper GI Unit (Auckland City Hospital) and by HBP/Upper GI Surgeons Ltd (Mercy Integrated Hospital) between 1999 and 2006 were identified by audit systems and the clinical records were reviewed. Outcome was determined by a separate telephone survey using a derivative of validated questionnaires. Results From the 1499 admissions of 1092 patients, there were 81 (7%) patients (median age 44 years, range 11–76, male : female 1.7 : 1) who had surgery. The Japan Pancreas Society criteria determined that 64 patients had definite CP (9 with cancer), 10 with probable CP, and 7 without evidence of CP (2 with cancer). ERCP was performed in 41 (50%) patients (20 diagnostic and 21 therapeutic procedures, 11 had pancreatic stenting as a therapeutic trial). There were 42 resections (right side 24, left side 18) and 32 decompressions (Frey 29, Partington‐Rochelle 3) and 7 cysto‐enterostomies. There was no 30 day mortality, a major complication rate of 5% and an overall median hospital stay of 12 days (range 2–82). The results for long‐term clinical outcome demonstrated sustained benefit in the majority of patients. Conclusions Surgery for CP can be performed safely and with sustained clinical benefit in a carefully selected and small subgroup of patients.