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Article
April 1977

Absence of Pancreatic Duct Dilation in Chronic PancreatitisSurgical Significance

Author Affiliations

From the Department of Surgery (Drs Grodsinsky and Block) and the Division of Gastroenterology (Dr Schuman), Henry Ford Hospital, Detroit.

Arch Surg. 1977;112(4):444-449. doi:10.1001/archsurg.1977.01370040096015
Abstract

• Of 22 patients treated surgically for intractable pain from chronic alcoholic pancreatitis, eight did not show notable dilation of the main pancreatic duct by endoscopic retrograde cholangiopancreatography (ERCP), operative pancreatography, and/or operative and microscopical studies of the pancreas after subtotal pancreatectomy. In all patients, far advanced parenchymal pancreatitis was evident at operation and by microscopical study of the removed portion of the pancreas. These findings indicate that the basic problem in a considerable number of patients with symptomatic alcoholic chronic pancreatitis is not related primarily to obstruction with dilation of the major pancreatic duct, but to intrinsic changes in the parenchymal pancreas. The preoperative use of ERCP and individualization of operative procedures with a preference for subtotal or partial pancreatectomy for symptomatic chronic alcoholic pancreatitis are supported.

(Arch Surg 112:444-449, 1977)

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