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January 7, 1950

FIBROCYSTIC DISEASE OF THE PANCREASTreatment by Sympathetic Denervation of the Pancreas and Presentation of a Theory of Neuroeffector Mechanisms: Preliminary Report of Five Cases

Author Affiliations

New Orleans

From the Departments of Surgery (Drs. Ayers and Ochsner) and Pediatrics (Dr. Stowens), Tulane University School of Medicine, and the Ochsner Clinic.

JAMA. 1950;142(1):7-12. doi:10.1001/jama.1950.02910190009002

Since recognition of fibrous replacement of the acini of the pancreas associated with severe nutritive and respiratory disease as a pathologic and clinical entity in 1938,1 remarkable advances have been made in the treatment of pancreatic fibrosis, which has resulted in prolonging the life of these patients. Such treatment has been primarily dietary, supplementary and prophylactic against recurrent and intercurrent infections. This has resulted in extension but not alteration of the uniformly fatal prognosis of this disease.

A new method of treatment consisting of sympathetic denervation of the pancreas by splanchnic block with procaine hydrochloride and complete splanchnicectomy on the right side has been employed by us in 5 cases with spectacular immediate results. These cases together with the presentation of a theory of neuroeffector mechanisms form the basis of this report. The diagnosis in each of our cases was established by demonstration of absence of pancreatic enzyme (trypsin)

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