[Effect of morphological state of pancreatic parenchyma on the long-term outcome of surgery for chronic pancreatitis].

Objective: To determine the effect of baseline morphological state of the pancreas on the long-term outcomes of duodenum-preserving pancreatic head resection (DPPHR).

Material And Methods: The study included 104 patients with chronic pancreatitis (CP), who underwent DPPHR in 2014-2019. Pain syndrome, exocrine and endocrine pancreatic insufficiency and quality of life (QoL) were assessed in long-term postoperative period. Patients were stratified depending on CT enhancement of pancreatic parenchyma as an indicator of fibrosis and amount of preserved acinar cells in resected pancreatic tissue.

Results. S: Ignificant relief of pain syndrome in long-term period was observed in patients with higher density of pancreatic tissue in venous phase of CT compared to delayed phase. Moreover, these patients needed less additional enzyme intake and had higher QoL. Exocrine insufficiency depended on the number of preserved acinar cells. The percentage of preserved acinar cells also affects the QoL of patients with CP. There were no correlations between endocrine insufficiency and CT-findings, as well as the number of preserved acinar cells.

Conclusion: Higher CT-density of pancreatic parenchyma in venous phase indicates a lesser degree of fibrosis. It is a favorable prognostic factor for postoperative pain relief and preservation of exocrine function. The percentage of preserved acinar cells in the resected pancreatic tissue is a reliable predictor of exocrine insufficiency.