PANCREATIC SURGERY

Attempts to treat acute pancreatitis with protease inhibitors and secretion inhibitors have been unsuccessful. Endoscopic therapy for acute pancreatitis is beneficial because it reduces the incidence of biliary sepsis. Pancreas divisum may be treated successfully by endoscopic placement of a dorsal duct stent. Asymptomatic pseudocysts can be safely observed rather than drained even if they persist for more than 6 weeks. Extended pancreatic resections may improve the survival rate for patients with locally invasive cancer. Pylorus-preserving resection may be less appropriate than the standard Whipple's resection for pancreatic head carcinomas. Endoscopic ultrasonography may be useful in localizing islet cell tumors. Combined pancreas and kidney transplantation is associated with a better outcome than is isolated pancreas allotransplantation in diabetic patients.