6年間の経過観察中に4回も開腹手術が行われた慢性膵炎の1症例

A Cage of Chronic Progressive Pancreatitis Operated on Four Times during Six Years' Observation

　日本膵臓病研究会試案¹⁾によって，高度の慢性膵炎に限っては，統一した基準のもとに診断が容易にできるようになった．しかし軽度の慢性膵炎に対する診断基準は確立されておらず，今後の検討課題となっている．それに加えて，治療面では対症療法に終始しがちで，たとえ高度の慢性膵炎においても，手術適応に関しては今なお議論の分かれるところである．本疾患には未解決な問題が数多いことはわれわれが指摘するまでもない．

　われわれは慢性膵炎の診断が確定したのち6年の長きにわたり頑固な腹痛に悩まされ内科への入院を9回繰り返し，この間に4回の開腹手術をうけた36歳男性の症例を経験した．以下その臨床経過の概要とその手術結果について報告する．

　We have experienced a case of chronic pancreatitis in a 36-year-old man who had to undergo operations four times during nine times of admission to the hospital over a period of six years. We report here the clinical development and the records of operations in this case, referring also to many problems awaiting solutions such as indications for operation, a most suitable method for it and some markers for the grade of progression in chronic pancreatitis. The patient is getting better after pancreatojejunostomy done at the fourth operation.

　As this case has been complicated during its course with diabetes mellitus and stones in the biliary tract and pancreas, we have to pay strict attention to possible complications in the treatment of chronic pancreatitis. At the same time, the development of suitable markers for judging the progress of this disease is eagerly awaited.