Chirurgische therapie bei der chronischen pankreatitis

Chronic pancreatitis is characterized by recurrent episodes of pancreatitis and a chronic pain syndrome. The pancreatic structure becomes more and more fibrotic, and the patients suffer from exocrine and endocrine pancreatic insufficiency. The pathogenesis of the pain is based on the release of inflammatory cytokines, changes of the sensory nerves, and an increase of the intraductal and parenchymal pressures in the pancreas. The surgical therapy consists of drainage operations and/or pancreatic resections. In the last decade organ-preserving operations such as the duodenum-preserving pancreatic head resection has evolved. Prospective studies demonstrated better results for duodenum-preserving pancreatic head resection in terms of quality of life and endocrine function. After modern pancreatic surgery, up to 90% of the patients are free of pain, and over 70% sustain a normal quality of life index.