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June 1957

Pancreaticoduodenectomy for Chronic Relapsing Pancreatitis: Metabolic Defects Created by Total and Subtotal Ablations

Author Affiliations

Los Angeles
From the Departments of Surgery and Medicine, Wadsworth General Hospital, Veterans' Administration Center, and University of California Medical Center. Assistant Chief of Surgery, Veterans' Administration Center and Assistant Clinical Professor of Surgery, University of California Medical Center (Dr. Jordan); Chief of Gastroenterology, Veterans' Administration Center and Associate Clinical Professor of Medicine, University of California Medical Center (Dr. Grossman).

AMA Arch Surg. 1957;74(6):871-880. doi:10.1001/archsurg.1957.01280120049005

Although von Mering and Minkowski were successful in removing the pancreas from the dog in 1889, it was almost 50 years before a similar procedure was accomplished in man. In 1935 Whipple16 performed the first subtotal pancreaticoduodenectomy, and in 1944 Priestley12 performed the first successful total pancreatectomy. During the two decades since Whipple's operation was originally described, pancreatectomy has been utilized with increasing frequency in the treatment of an array of benign and malignant diseases.

The incidence of unsatisfactory results that are obtained in the treatment of chronic relapsing pancreatitis with indirect surgical procedures has stimulated interest in the treatment of this disease by more direct operative techniques, including resection of the pancreas.2 A similar dissatisfaction with the results obtained by less radical but more conventional methods of treatment also prompted us to evaluate pancreaticoduodenectomy in selected cases that are characterized by far-advanced architectural changes of the

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