Abstract
The recommendations concerning surgical therapy in Japanese guidelines revised in 2015 have been summarized as follows. Surgical therapy is recommended to be selected for the cases with intractable pain in which endoscopic therapy is neither effective nor possible. Concerning the selection of surgical procedures, in the cases with the dilated main pancreatic duct the pancreatic duct drainage operation such as side-to-side pancreaticojejunostomy should be selected, and pancreatectomy can be selected in the cases without pancreatic duct dilatation. In the cases with both the main pancreatic duct dilatation and the calcification in the pancreas head, Frey procedure rather than Beger procedure is recommended to be selected in Japan because the perioperative morbidity is less frequent in the Frey procedure, and because Beger procedure is not popular in Japan. In the clinical stage without pancreatic insufficiency (the compensated stage), the operation with pancreatic duct drainage may be beneficial for the maintenance of pancreatic function.
