Abstract The early report by Darling,8 followed by the extensive studies of Gambill, Comfort, and Baggenstoss,* has, in the past decade, stimulated an increasing interest in the problem of relapsing pancreatitis, an interest necessitated by the inherent difficulties in treatment. Several of the earlier reports indicated that relapsing pancreatitis, in contradistinction to simple acute pancreatitis, was not characteristically associated with cholelithiasis. This experience led to the hypothesis that relapsing pancreatitis might be a primary disease of the pancreas, with biliary concretions playing a rather unimportant role in etiology. More recent studies of a large series of patients reveal that the incidence of cholelithiasis is essentially the same in relapsing pancreatitis as in simple acute pancreatitis.18 Of real importance is the observation that the results of treatment are distinctly better in those patients with biliary-tract disease than in those without. Most authors advocate thorough exploration of the biliary tree with References 1. References 5 and 13. 2. Barclay, S.: Operative Relief of Recurrent Pancreatitis , New Zealand M. J. 49:419-423, 1950. 3. Blackburn, G., and Large, P. G.: Pancreatitis Acute and Relapsing , Practitioner 171:641-647, 1953. 4. Bowers, R. F.: Surgical Therapy for Chronic Pancreatitis , Surgery 30:116-129, 1951. 5. Cogswell, H. D.: Recurrent Pancreatitis , Am. Surgeon 17:209-217, 1951. 6. Comfort, M. W.: Chronic Relapsing Pancreatitis: Its Clinical Course, Sequelae, Diagnosis and Medical Treatment in Cases in Which Disease of the Biliary or Gastro-Intestinal Tract Did Not Coexist , Proc. Staff. Meet. Mayo Clinic 22:548-552, 1947. 7. Comfort, M. W., and Steinberg, A. G.: Pedigree of a Family with Hereditary Chronic Relapsing Pancreatitis , Gastroenterology 21:54-63, 1952. 8. Connolly, J. E., and Richards, V.: Bilateral Splanchnicectomy and Lumbodorsal Sympathectomy for Chronic Relapsing Pancreatitis , Ann. Surg. 131:58-63, 1950.Crossref 9. Darling, H. C. R.: A Case of Progressive Calcification of the Pancreas Secondary to Chronic Relapsing Pancreatitis , M. J. Australia 2:7-8, 1942. 10. De Takats, G.; Walter, L. E., and Lasner, J.: Splanchnic Nerve Section for Pancreatic Pain: Second Report , Ann. Surg. 131:44-57, 1950.Crossref 11. Doubilet, H., and Mulholland, J. H.: Recurrent Acute Pancreatitis: Observations on Etiology and Surgical Treatment , Ann. Surg. 128:609-638, 1948.Crossref 12. Doubilet, H., and Mulholland, J. H.: The Surgical Treatment of Recurrent Acute Pancreatitis by Endocholedochal Sphincterotomy , Surg. Gynec. & Obst. 86:295-306, 1948. 13. Edmondson, H. A.; Bullock, W. K., and Mehl, J. W.: Chronic Pancreatitis and Lithiasis: Clinicopathologic Study of 62 Cases of Chronic Pancreatitis , Am. J. Path. 25:1227-1247, 1949. 14. Gambill, E. E.; Comfort, M. W., and Baggenstoss, A. H.: Chronic Relapsing Pancreatitis: An Analysis of 27 Cases Associated with Disease of the Biliary Tract , Gastroenterology 11:1-33, 1948. 15. Horton, R. E.: Chronic Relapsing Pancreatitis: Some Notes on Its Pathology, Diagnosis and Treatment , Guy's Hosp. Rep. 96:226-236, 1947. 16. Hurwitz, A., and Gurwitz, J.: Relief of Pain in Chronic Relapsing Pancreatitis by Unilateral Sympathectomy , Arch. Surg. 61:372-378, 1950. 17. Hyman, H. L., and Burton, C. C.: Treatment of Chronic Relapsing Pancreatitis by Sympathectomy and Splanchnicectomy , Gastroenterology 18:43-48, 1951. 18. Jones, S. A., and Smith, L. L.: Transduodenal Sphincteroplasty for Recurrent Pancreatitis: Preliminary Report , Ann. Surg. 136:937-947, 1952. 19. Kaden, V. G., and Howard, J. M.: Clinical Studies of the Natural History of Acute Pancreatitis , A. M. A. Arch. Surg. 73:269-271, 1956. 20. Klatskin, G., and Gordon, M.: Relationship Between Relapsing Pancreatitis and Essential Hyperlipemia , Am. J. Med. 12:3-23, 1952. 21. Maimon, S. N.; Kirsner, J. B., and Palmer, W. L.: Chronic Recurrent Pancreatitis: A Clinical Study of 20 Cases , Arch. Int. Med. 81:56-72, 1948. 22. Major, J. W., and Ottenheimer, E. J.: Transduodenal Sphincterotomy for Chronic Relapsing Pancreatitis , New England J. Med. 248:130-132, 1953.Crossref 23. Marx, R.: Chronic Relapsing Pancreatitis: Surgical Approaches , Ann. West. Med. & Surg. 5:203-206, 1951. 24. McCleery, R. S.; Kesterson, J. E., and Schaffarzick, W. R.: A Clinical Study of the Effect of Vagotomy on Recurrent Acute Pancreatitis , Surgery 30:130-147, 1951. 25. McLaughlin, E. F., and Harris, J. S. C.: Total Pancreatectomy for Recurrent Calcareous Pancreatitis , Ann. Surg. 136:1024-1030, 1952. 26. Nothman, M. M.: Chronic Relapsing Pancreatitis , Bull. New England M. Center 11:182-192, 1949. 27. Poth, E. J., and Wolma, F. J.: The Treatment of Recurring Acute Pancreatitis by Decompression of the Biliary Tract , Am. Surgeon 20:270-281, 1954. 28. Priestley, J. T.; Taylor, L. M., and Rogers, J. D.: Surgical Treatment of Chronic Relapsing Pancreatitis , Surgery 37:317-336, 1955. 29. Probstein, J. G.: Pancreatitis: Current Concepts , J. Internat. Coll. Surgeons 18:489-493, 1952. 30. Rack, F. J., and Elkins, C. W.: Experiences with Vagotomy and Sympathectomy in the Treatment of Chronic Recurrent Pancreatitis , Arch. Surg. 61:937-943, 1950. 31. Raker, J. W., and Bartlett, M. K.: Acute Pancreatitis: The Fate of the Patient Surviving One or More Attacks , New England J. Med. 249:751-757, 1953. 32. Richman, A., and Colp, R.: Subtotal Gastrectomy in the Treatment of Chronic Recurrent Pancreatitis , J. Mt. Sinai Hosp. 15:132-138, 1948. 33. Rousselot, L. M.; Sanchez-Ubeda, R., and Giannelli, S.: Choledochoenterostomy in Chronic Relapsing Pancreatitis , New England J. Med. 250:267-272, 1954. 34. Selesnick, S.: Recurrent Jaundice in Chronic Relapsing Pancreatitis , Gastroenterology 21:230-237, 1952. 35. Starkloff, G. B.; Knight, W. A., Jr., and Pollock, R.: The Management of Chronic Pancreatitis: A Critical Evaluation , Am. Surgeon 20:435-444, 1954.
A.M.A. Archives Surgery – American Medical Association
Published: Dec 1, 1956
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