Long term results of lateral pancreaticojejunostomy for chronic alcoholic pancreatitis

Abstract

Objective: To assess our long term results of lateral pancreaticojejunostomy in patients with alcoholic pancreatitis. Design: Retrospective study. Setting: University hospital, France. Subjects: 57 patients (48 men, 9 women, mean (SD) age 46 (7) years who required surgical treatment of chronic alcoholic pancreatitis between January 1977 and October 1995. Interventions: Lateral pancreaticojejunostomy with or without another procedure. Outcome classified as excellent, good, fail or poor. Main outcome measures: Postoperative morbidity and mortality; relief of pain; reduction in use of analgesics and exocrine supplements; effect on exocrine and endocrine insufficiency; and return to paid work. Results: There were no postoperative deaths and no pancreatic fistulae, but there were 17 other postoperative complication (30%). Median follow up was 65 months (range 8-206), during which 12 patients died (21%). Result was judged excellent in 16 (28%), good in 27 (47%), fair in 5 (9%), and poor in 9 (16%). Pain control was significantly improved, analgesic usage decreased, less pancreatic enzyme supplementation was required, and 25 patients returned to paid work (p = 0.0001 in each case). Exocrine and endocrine function remained stable. The results were better if the patient gave up misusing alcohol (p = 0.03) and if the operation was done within 4 years of the development of pancreatitis (p = 0.03). Conclusions: Lateral pancreaticojejunostomy is a safe procedure that can improve functional outcome in patients with chronic alcoholic pancreatitis, and does not worsen pancreatic function.