Treatment of chronic pancreatitis (CP) is a challenging disease for surgeons. During the last several decades, increasing knowledge about pathophysiology of CP, improved results of major pancreatic resections, and development of sophisticated diagnostic methods in clinical practice have resulted in significant changes in surgery for CP. Main indications of CP for surgery are intractable pain, suspicion of malignancy, and involvement of adjacent organs. The goal of surgical treatment is to

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... e the quality of life of patients. The surgical approach to CP should be individualized according to pancreatic anatomy and pathophysiology, pain characteristics, baseline exocrine and endocrine function, and medical co-morbidity. The approach usually involves pancreatic duct drainage and resection including longitudinal pancreatojejunostomy, pancreatoduodenectomy (Whipple's procedure), pylorus-preserving pancreatoduodenectomy, distal pancreatectomy, total pancreatectomy, duodenum preserving pancreatic head resection (Beger's procedure), and local resection of the pancreatic head with longitudinal pancreatojejunostomy (Frey's procedure). Surgical procedures provide long-term pain relief, a good postoperative quality of life with preservation of endocrine and exocrine pancreatic function, and are associated with low early and late mortality and morbidity. Even though available results from randomized controlled trials were published, new studies are needed to determine which procedure is the most effective for the management of patients with CP. (Korean J Med 2012;83:40-49) Keywords: Chronic pancreatitis; Surgical treatment 서 론 만성췌장염은 만성적인 음주, 담도계 질환, 부갑상선 기 능항진증, 외상 등 여러 원인에 의하여 내분비 및 외분비췌 장의 부전과 함께 췌장실질의 파괴와 췌장샘의 소실, 췌장샘 의 수축, 증식성 섬유화, 석회화, 췌관의 협착 등이 진행되는 만성적이고 비가역적인 질환이다. 이에 비해 급성췌장염은 담석, 음주, 대사 장애, 약물, 복부 손상 등의 다양한 원인에 의해 췌장선 세포의 손상, 광범위한 간질성 부종, 출혈 등이 일어나는 췌장의 급격한 염증성 질환으로서 환자의 70-80% -Dongho Choi. Surgical treatment of chronic pancreatitis -