From 1972 to 1986, 246 patients, with a large majority of alcoholics, were operated on for chronic pancreatitis. Mean age was 44.2 ± 23.4 years and the male/female sex ratio was 217/29. In 223, 22 and 1 patients, 1, 2 or 3 laparotomies were performed, respectively. In 12 patients laparotomy was only explorative. In all others, at each laparotomy, 1 surgical procedure was performed in 207 patients, 2 procedures in 42, 3 procedures in 8 and 4 procedures in 1. These various procedures were as follows: external drainage: 17; biliary, gastric, pancreatic, cystic internal diversions: 142; distal pancreatectomy: 51; pancreaticoduodenectomy: 47; total pancreatectomy: 1. Abdominal pain was the most frequent symptom (60%). Morphological features other than pancreatic abnormalities were frequent: biliary and duodenal obstructions account for 40 and 23.5% of the surgical indications, respectively. The choice among these numerous surgical options are presented in detail and discussed. Overall operative mortality was 7.7% (patients), 7% (laparotomy), 9% in the resection group and 5.8% in the other group. Our best long-term results were observed after the Whipple procedure with a 15-year survival rate of 74.5%.

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