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EXPERIENCES WITH VAGOTOMY AND SYMPATHECTOMY IN THE TREATMENT OF CHRONIC RECURRENT PANCREATITIS

FRANK J. RACK, M.D.; CHARLES W. ELKINS, M.D.
AMA Arch Surg. 1950;61(5):937-943. doi:10.1001/archsurg.1950.01250020945015.
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THE CONTROL of pain is one of the most difficult problems encountered in patients with chronic recurrent pancreatitis. Diabetes, steatorrhea, creatorrhea, cyst formation, jaundice, necrosis, fibrosis and calcification are seen with variable frequency. But the most distressing feature both to the patient and to the surgeon is the pain, which is usually severe, recurrent and disabling.

Both medical and surgical measures have been advocated as treatment in this condition.1 Comfort and his associates2 recommended conservative surgical procedures such as drainage of the biliary tract and pancreatic cysts for the milder cases and partial or total pancreatectomy for the relief of persistent and disabling pain. Exploration of the biliary tree with drainage of the common bile duct and cholecystectomy can be well justified when associated biliary tract disease is demonstrated. However, in many patients no abnormalities of the biliary system can be found either preoperatively or at operation. In

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