The sequelae of pancreas surgery are determined by the type of procedure, the extent of the parenchymal resection and the underlying disorder. In ductal carcinoma, the outcome is heavily influenced by the disease itself. Mortality rates are lower in centers which perform the most operations. In chronic pancreatitis, surgical management is essentially therapeutic for complications and palliative for the disease whose progress is closely correlated with the sequelae. Elective surgery does not appear to increase the risk of diabetes whereas distal pancreatectomy is an independent risk factor. Parenchymal resection aggravates nutritional deficiencies, such as low selenium, linoleic acid, LDL and apolipoprotein B levels, and thus increases the risk of atherogenesis. Abstinence from alcohol is an indispensable step towards the disappearance of postoperative pain.
Ezio Gaia, Paola Salacone