Iii27

Figure 3-1 Side-to-side pancreaticojejunostomy for complete drainage of the entire main pancreatic duct.

Figure 3-2 Extent of resection in the Longmire-Whipple procedure. (From Traverso, L. W., and Longmire, W.P.: Preservation of the pylorus in pancreaticoduodenectomy: A follow-up evaluation. Ann. Surg., 192:307, 1980, with permission.)

rocedure. (From Traverso, L. W„ and Longmire, W.P.: Preservation of the pylorus in pancreaticoduodenectomy: A follow-up evaluation. Ann. Surg., 192:307, 1980, with permission.)

Figure 3-2 Extent of resection in the Longmire-Whipple procedure. (From Traverso, L. W., and Longmire, W.P.: Preservation of the pylorus in pancreaticoduodenectomy: A follow-up evaluation. Ann. Surg., 192:307, 1980, with permission.)

Figure 3-4 Subtotal resection of the pancreatic head with preservation of the distal pancreas. (From Beger, H.G., Krautzberger, W., Bittner, R., etal.: Duodenum-preserving resection of the head of the pancreas in patients with severe chronic pancreatitis. Surgery, 97:468, 1985, with permission.)

Figure 3-5 Restoration of pancreaticoenteric drainage after the Beger procedure. (From Beger, H.G., Krautzberger, W., Bittner, R., etal.: Duodenum-preserving resection of the head of the pancreas in patients with severe chronic pancreatitis. Surgery, 97:469, 1985, with permission.)

Figure 3-6 Lateral p ana e atl coj eju no sto my modified by limited resection or "coring out" of the pancreatic head. (From Frey, C.F., and Smith, G.J.: Description and rationale of a new operation for chronic pancreatitis. Pancreas, 2:702, 1987, with permission.)

Figure 3-7 General anatomy and plan of operative procedure for complete denervation of the pancreas. The dotted line denotes the limits of dissection. (From Hiraoka, T„ Watanabe, E., Katoh, T„ etal.: A new surgical approach for control of pain in chronic pancreatitis: Complete denervation of the pancreas. Am. J. Surg., 152:550, 1986, with permission.)

Figure 3-8 Splenopancreatic flap procedure. After subtotal resection of the pancreatic head and ligation of splenic vessels, the body and the tail of the pancreas are dissected free from the retroperitoneum. Vascularity is preserved via antegrade flow from the splenic hilus. (From Shires, G.T., III, MOlikan, W.J., Henderson, J.M., et al.: Denervated splenopancreatic flap for chronic pancreatitis. Ann. Surg., 203:569, 1986, with permission.)

L ¡gatea splenic a

Figure 3-9 Technique of segmental pancreatic autotransplantation. Splenic vessels are anastomosed to the femoral vessels. The pancreatic duct Is ligated or occluded with synthetic polymer. (From Hogle. H.H.. and Reemtsma. K.: Pancreatic autotransplantation following resection. Surgery. 82:360. 1978. with permission.)

Splenic

Splenic

Vein Splenic Femoral

Artery Artery

Splenic Femoral Vein Vein

TABLE 3-1 -- Results of Near-Total Pancreatectomy and Segmental Pancreatic Autotransplantation for Chronic Pancreatitis (1978-1987)

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