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December 1959

Surgical Management of Chronic Pancreatitis

Author Affiliations

Present address of Dr. H. Jones and Dr. Odell, Medford, Ore.

AMA Arch Surg. 1959;79(6):950-955. doi:10.1001/archsurg.1959.04320120092010

The purpose of this exhibit is to present the practical aspects of the etiologic mechanisms and the surgical management of this disease.

Pancreatitis is a disease of multiple causes.

Repeated episodes of pancreatitis, edema, and necrosis lead to chronic pancreatitis.

Pancreatic ductal obstruction exists in most instances.

The majority of cases are associated with biliary tract disease and/or alcoholism.

In some patients no causative factor can be found.

Alcohol  The incidence of alcoholism in patients with pancreatitis is high. Alcohol stimulates pancreatic flow and at the same time causes pancreatic ductal obstruction.

Other Causes  Other causes of pancreatitis are as follows:TraumaMetabolic disturbancesHeredityToxic conditionsVascularInfection

Surgical Management Selection of Patients  IndicationsDemonstrable biliary tract diseaseIntractable painDuodenal loop changes with or withoutobstructionQuestionable carcinomaProgressive pancreatic insufficiencyPancreatic calcinosisContraindicationsContinuing alcoholismContinuing drug addictionSurgical procedures must be altered to meet the varied

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