2017 Volume 32 Issue 5 Pages 836-842
Background: Surgery for chronic pancreatitis (CP) is mainly classified into two groups: drainage of pancreatic duct and pancreatectomy. It is important to select the optimal procedure according to the condition of the pancreas. We encountered a CP patient who received subtotal stomach-preserving pancreaticoduodenectomy (SSPPD) with longitudinal pancreatojejunostomy (LPJ) due to severe inflammation at the pancreatic head and duodenum.
Course of treatment: A male in his 40's was admitted to our hospital due to an acute exacerbation of CP. Preoperative examinations revealed calcification of the pancreatic head and cystic lesions with hematoma near the pancreatic head. In addition, a stenotic duodenum with a fistula and calcification in the pancreatic tail were seen. Though Frey's procedure has been selected as the first choice of the surgical therapy for CP in our institution, we selected SSPPD with LPJ in this case because the inflammation of the pancreatic head had extended to the duodenum and the therapeutic effect of Frey's procedure might have been insufficient. Though the patient had postoperative intraperitoneal abscess, it was diminished by drainage. He was discharged without any symptoms.
Conclusion: SSPPD with LPJ can be considerable for cases in which inflammation of the pancreatic head is too severe and the therapeutic effect of Frey's procedure might be insufficient.
