Life after Total Pancreatectomy for Chronic Pancreatitis

Abstract

The operation is reserved for those with prolonged and severe pancreatitis, for whom previous less radical operations were unsuccessful, and whose pancreas has been extensively destroyed by the inflammatory process. Satisfactory long-term relief of pain was obtained in 5 of 6 patients. The diabetic state remained stable in these patients; and their nutrition and weight are maintained on a high carbohydrate, high protein, and low fat diet together with the use of desiccated whole pancreas in large doses. They are able to work full-time. The jejunal ulceration rate will be high unless total pancreatectomy is combined with subtotal gastrectomy or hemigastrectomy with bilateral vagotomy, the latter being preferred, as total pancreatectomy is already an invitation to metabolic disturbances. Frequent follow up visits are essential.