Somogyi's contribution of the test for serum amylase1 has made possible the more frequent diagnosis of pancreatitis, with the result that nonsurgical treatment for the disease can be used oftener. The edematous type of pancreatitis, which is found more commonly and which may manifest itself in repeated attacks, usually responds well to conservative treatment. The more fulminating hemorrhagic type in which there is free fluid in the peritoneal cavity still carries a high mortality.
The recognition of pancreatic duct obstruction, whether it be secondary to obstruction at the ampulla of Vater, due to extrinsic compression of the ampulla or pancreatic duct, or within the pancreatic duct itself, as a factor in the cause of pancreatitis has gradually led to measures directed toward decompression of the pancreatic ductal system or removal of the element of obstruction. Removal of a calculus from the common bile duct and Doubilet's operation of sphincterotomy
HILL RL, JUDD CS, SHAW WR, BOYAR WT. Pancreatic Ductal Decompression in Chronic Pancreatitis with Fistula. AMA Arch Surg. 1955;71(5):710-711. doi:10.1001/archsurg.1955.01270170068011