The article presented a first 52-year woman with chronic pancreatitis and pancreatic stone who underwent Frey’s procedure at ViÖt - §øc Hospital in January 2002. This patient had admitted to hospital due to abdominal pain with vomiting. The general condition was poor; body weight was 35 kg. Skin and mucous membrane was not yellow. The patient had not edema or subcutaneous hemorrhage, blood pressure was 150/100 mmHg, and pulse was 85 rates per minute. She had history of uncontrolled hypertension. The postoperative outcome was good. The patient could eat light meal by 3 days after operation. Drain catheters were removed after 72 hours. She was free from pain. Sutures were removed after 7 days and she was released after 12 days. After 2-month follow-up, she had normal diet and activities
Pancreatitis, Chronic ; surgery ; therapeutics

The most vulnerable age group is 31-50 years old (52.3% of patients) with a sex ratio of male/female was 1/1, and the main causes of the great majority of cases are undetermined. The treatment is mainly preservative at a surgical institution and the severe complications must be promptly interventional surgical.
Pancreatitis ; epidemiology ; therapeutics ; surgery

Acute Disease ; Humans ; Pancreas ; Pancreatitis ; surgery ; Pancreatitis, Acute Necrotizing

The management of pancreatitis remained controversial over the past decades, varying from conservative medical treatment to surgical treatment. However, in recent years, treatment of severe acute pancreatitis is shifting from an early surgical debridement and necrosectomy to an aggressive intensive medical care. While the treatment is conservative in the earlier phase of the disease, surgery might be considered in the later phase. In chronic pancreatitis and in pancreatic pseudocyst, various surgical approaches are available these days. Apart from the conventional open surgery, laparoscopic procedure became popular since it is minimally invasive and effective. In addition, with the great improvements in interventional radiology and endoscopic techniques, multidisciplinary approaches including medical, interventional, and surgical management become much more important in the proper treatment of pancreatitis. In this review, pancreatitis is classified into three categories (acute pancreatitis, chronic pancreatitis, and pancreatic pseudocyst) for convenience, and the surgical treatment is described in each category.
Acute Disease ; English Abstract ; Humans ; Pancreatic Pseudocyst/surgery ; Pancreatitis/*surgery ; Pancreatitis, Chronic/surgery

Through 10 cases of calculus of the pancreas chronical pancreatitis calcified in head, trunk and tail of the pancreas, associated with the dilatation of the main duct of pancreas (6/10 patients were alcoholism, 10/10 had got abdomen pain treated internally, 10/10 ahd weight loss, 3/10 with the syndrom of bile obstruction, 2/10 with diabetes) operated by a combing surgery of Frey and Beger method, without death. Premiminary results showed that the pain was reduced, chronical pancreatitis was controlled and the complications for neighbourhood organs caused by this condition, such as bile obstruction, main bile duct obstruction..) were prevented. The excretion and endocrinological functions of the pancreas were preserved, living quality was obviously improved.
Surgery ; Therapeutics ; Pancreatitis, Chronic ; Lithiasis ; Pancreas

Severe acute pancreatitis (SAP) is hard to treat for the abrupt onset, critical condition and complicated pathophysiology. Historically, the treatment strategy of SAP hovered between surgical intervention and conservative treatment. At the turn of the 20(th) century, SAP was reported to be cured by surgical intervention in a series cases, which lead to the dominance of surgical intervention in SAP treatment. Subsequently, SAP was documented to respond to nonoperative therapy. A wave of conservatism emerged, and surgical intervention for SAP was rarely practiced for the next 3 decades. However, surgeons refined the indications and considered new approaches for surgical treatment in 1960s because of the poor outcomes of conservation, and surgical interventions was mainly performed at early stage of SAP. However, a series of prospective studies showed that conservative treatment of patients with sterile pancreatic necrosis is superior to surgical intervention, and that delayed intervention provide improved outcomes in 1990s, which changed the treatment concept of SAP again. The modern treatment concept formed during the progression: organ supportive care dominates in the early stage of the disease, and surgical intervention should be performed at late stage with proper indications. Despite the advances in treatment, the morbidity of SAP is still 5%-20%, which suggests the pancreatic surgeons' exploration in the future.
Disease Progression ; History, 20th Century ; Humans ; Pancreatectomy ; history ; Pancreatitis ; surgery

Critical Illness ; Humans ; Pancreatitis, Acute Necrotizing ; diagnosis ; surgery ; therapy

OBJECTIVETo compare the safety and effectiveness of DPPHR with PPPD/PD for treating chronic pancreatitis with an inflammatory mass in the head of pancreas.

METHODSThe relative data bases such as Medline, EMBase, Biosis, COCHRANE Library, Science Citation Index, SinoMed, Chinese Journal Full-text Database, Wangfang, CNKI were searched systematically, researchers selected randomized controlled trials (RCT) and prospective clinical controlled trials (CCT) . The assessment of the bias risk of the included trials was according to the assessing tools suggested by Cochrane Handbook 5.1. The Review Manage 5.2 was used to perform the statistical analysis.

RESULTSIn total, 5 RCTs and 2 CCTs were included, 381 patients involved. Comparing with PPPD/PD procedure, DPPHR has no significant difference in terms of the mortality of perioperative period (RD = 0.01, P = 0.51), the incidence of bleeding (RD = -0.01, P = 0.72), pancreatic fistula(RD = -0.01, P = 0.59) and delayed gastric emptying (RD = -0.15, P = 0.10), the ration of complete pain relief after operation (RR = 1.06, P = 0.32) and the score of global quality of life (WMD = 10.31, P = 0.19).While DPPHR had significant superiorities in terms of the total morbidity of perioperative period (RR = 0.60, P = 0.008), the duration of the operations(WMD = -71.60, P = 0.03), the postoperative hospitalization duration(WMD = -3.95, P < 0.01), weight gain(WMD = 3.68, P < 0.01), occupational rehabilitation after the operations (RR = 1.38, P = 0.008).

CONCLUSIONSIn terms of reducing the morbidity of perioperative period, shortening the duration of the operations and the postoperative hospitalization duration, weight gain, occupational rehabilitation after the operations, the DPPHR is more favorable for improving patients' life qualities comparing with PPPD/PD.

Duodenum ; surgery ; Humans ; Pancreas ; surgery ; Pancreatectomy ; methods ; Pancreaticoduodenectomy ; methods ; Pancreatitis, Chronic ; surgery ; Prospective Studies ; Quality of Life

Female ; Gallstones ; pathology ; surgery ; Humans ; Hyperparathyroidism, Primary ; diagnosis ; surgery ; Pancreatitis ; pathology ; surgery ; Young Adult

Endoscopic therapy has been increasingly recognized as the effective therapy in selected patients with chronic pancreatitis. Utility of endotherapy in various conditions occurring in chronic pancreatitis is discussed. Its efficacy, limitations, and alternatives are addressed. For the best management of these complex entities, a multidisciplinary approach involving expertise in all pancreatic specialties is essential to achieve the goal.
Bile Ducts/surgery ; Enteral Nutrition ; Humans ; Pancreatic Ducts/surgery ; Pancreatic Pseudocyst/surgery ; Pancreatitis, Chronic/*surgery ; Sphincterotomy, Endoscopic/*methods ; Stents