Introduction to Chronic Pancreatitis Surgery

At MUSC, we have a particular interest in patients with chronic pancreatitis, dedicating a multidisciplinary effort to the care of this challenging disease. We have had a longstanding tradition in surgical management of chronic pancreatitis that was developed by Dr. Marion Anderson, a former Department Chairman and highly respected national leader in the operative treatment of chronic pancreatitis. Dr. David B. Adams, Professor of Surgery and current Head, Section of General and Gastrointestinal Surgery at MUSC, began working with Dr. Anderson in 1986 and has continued the tradition established by Dr. Anderson in specialized surgical treatment of chronic pancreatitis. Dr. Katherine A. Morgan, also with a special interest in pancreatitis, has been a member of the pancreas surgery team since 2003.

Operations to treat complications of chronic pancreatitis are done for a variety of reasons. The most common reason surgical treatment is undertaken is to treat pain associated with chronic pancreatitis.

One successful operation, known as the Puestow procedure, improves the drainage of the pancreas by draining the pancreatic duct into the small intestine. Another common procedure is to remove part of the diseased pancreas that has obstructed the pancreatic ducts. These procedures include removal of the head of the pancreas (the Whipple procedure) or removal of the tail and body of the pancreas (called a distal pancreatectomy).

Occasionally, drainage and partial removal procedures are combined (the Frey procedure). In some cases, the entire pancreas needs to be removed. This is called a total pancreatectomy. Currently, an exciting area in surgery (for chronic pancreatitis) combines removal of the entire pancreas with transplantation of the pancreatic cells that produce insulin in order to prevent diabetes. This is known as an islet cell autotransplantation.