Surgical management of chronic @entity788 : long-term results in 141 XXXX .

@entity1 @entity788 @entity66 @entity167 @entity660 @entity158
The management of @entity158 is a controversial subject and the treatment recommended varies from one extreme to the other. Some authorities advise simply waiting for chronic @entity788 to 'burn out', while others practise removal of the entire gland. In this paper we present 141 @entity1 who underwent surgery for chronic @entity788 at the Mayo Clinic. The main indication for operation was @entity158 and the choice of operation was based on anatomical abnormalities in the gland. The long-term results of the policy are reviewed (mean follow-up 8.5 years). Length of history, @entity66 , @entity660 and pathology, time after operation and continued @entity167 abuse were computer analysed for a statistically significant influence on @entity158 relief, ability to work, pancreatic function and survival. There was one operative death (mortality rate 0.7 per cent). Continued drinking was not shown to affect postoperative @entity158 relief but 10-year survival was significantly less in alcoholics than in those with non-alcoholic @entity788 (P less than 0.02). Dilated ducts and duct calculi were associated with good results for @entity158 relief although this association did not achieve statistical significance. Parenchymal calcification and time after operation did not influence the results of surgery. When the operation failed to relieve @entity158 , spontaneous remission occurred in a few cases only. Seventy-seven per cent of @entity1 had lasting relief of @entity158 and operations selected on the basis of gross pathology were equally effective in relieving @entity158 . Longitudinal pancreaticojejunostomy in those with dilated ducts and a Whipple operation for disease of the pancreatic head gave good results.(ABSTRACT TRUNCATED AT 250 WORDS)
