The Liverpool duodenum-and spleen-preserving near-total pancreatectomy can provide long-term pain relief in patients with end-stage chronic pancreatitis

2019 ◽  
Vol 404 (7) ◽  
pp. 831-840 ◽  
Author(s):  
A. R. G. Sheel ◽  
R. D. Baron ◽  
L. D. Dickerson ◽  
P. Ghaneh ◽  
F. Campbell ◽  
...  
Keyword(s):  
Chronic Pancreatitis ◽  
Pain Relief ◽  
Total Pancreatectomy ◽  
Spleen Preserving ◽  
End Stage

Duodenum- and spleen-preserving total pancreatectomy for end-stage chronic pancreatitis

2003 ◽  
Vol 90 (11) ◽  
pp. 1401-1408 ◽  
Author(s):  
N. Alexakis ◽  
P. Ghaneh ◽  
S. Connor ◽  
M. Raraty ◽  
R. Sutton ◽  
...  
Keyword(s):  
Chronic Pancreatitis ◽  
Total Pancreatectomy ◽  
Spleen Preserving ◽  
End Stage

Total Pancreatectomy for the Treatment of Chronic Pancreatitis: Indications, Outcomes, and Recommendations

2006 ◽  
Vol 72 (4) ◽  
pp. 297-302 ◽  
Author(s):  
Stephen W. Behrman ◽  
Matthew Mulloy
Keyword(s):  
Chronic Pancreatitis ◽  
Pain Relief ◽  
Total Pancreatectomy ◽  
Long Term Results ◽  
Gastrojejunal Anastomosis ◽  
Hereditary Pancreatitis ◽  
Anastomotic Complications ◽  
The Mean

Total pancreatectomy (TP) for chronic pancreatitis (CP) has not gained widespread acceptance because of concerns regarding technical complexity, diabetic complications, and uncertainty with respect to long-term pain relief. Records of patients having TP from 1997 to 2005 were reviewed. Patient presentation, etiology of disease, and the indication for TP were examined. Operative results were analyzed. Long-term results were critically assessed, including narcotic usage and the need for re-admission. Postoperative quality of life (QOL) was assessed by the SF-36 health survey. During the study period, 7 patients with CP had TP, and 28 had other operations. The etiology of CP was alcohol in four and hereditary pancreatitis in three. The indication for surgery was pain and weight loss. Preoperatively, all patients used narcotics chronically and two had insulin-dependent diabetes. Four had TP after failed previous surgical procedures. Endoscopic retrograde cholangiopancreatography and computed tomography demonstrated small ducts and atrophic calcified glands. The mean length of the operation was 468 minutes, and only two patients required transfusion. There were no biliary anastomotic complications. The mean length of stay was 14 days. Major morbidity was limited to a single patient with a leak from the gastrojejunal anastomosis. Thirty-day mortality was zero, with one late death unrelated to the surgical procedure or diabetes. The mean length of follow-up was 46 months. All patients remained alcohol and narcotic free. No patient was readmitted with a diabetic complication. When compared with the general population, QOL scores were diminished but reasonable. We conclude that TP is indicated in hereditary pancreatitis and in those with an atrophic, calcified pancreas with small duct disease; that TP is technically arduous but can be completed with very low morbidity and mortality; and that on long-term follow-up, pain relief and abstinence from alcohol and narcotics was excellent with an acceptable QOL.

Acute pain in peripheral vascular disease

2011 ◽  
Author(s):  
Arif H. Ghazi ◽  
Obi Agu
Keyword(s):  
Pain Relief ◽  
Vascular Disease ◽  
Peripheral Vascular Disease ◽  
Acute Pain ◽  
Peripheral Vascular ◽  
Surgical Revascularization ◽  
End Stage

Pain in vascular disease is often severe. Atherosclerosis is the commonest cause of ischaemic pain. Angioplasty, stents, and surgical revascularization should be attempted to treat the underlying cause. Pain relief is also aimed at neuropathic and sympathetic components of pain. In end stage ischaemic disease, amputation may be necessary often leading to long-term pain.

Role of total pancreatectomy in the treatment of patients with end-stage chronic pancreatitis

1995 ◽  
Vol 82 (10) ◽  
pp. 1409-1412 ◽  
Author(s):  
W. R. Fleming ◽  
R. C. N. Williamson
Keyword(s):  
Chronic Pancreatitis ◽  
Total Pancreatectomy ◽  
End Stage

Long-Term Survival after Total Pancreatectomy with Islet-Auto-Transplantation (TPIAT) for Chronic Pancreatitis

Pancreatology ◽  
2017 ◽  
Vol 17 (3) ◽  
pp. S74
Author(s):  
David Adams ◽  
Chung Catherine ◽  
Owczarski Stefanie ◽  
Wang Hongjun ◽  
Morgan Katherine
Keyword(s):  
Chronic Pancreatitis ◽  
Total Pancreatectomy ◽  
Term Survival ◽  
Long Term Survival

Duodenum-and spleen-preserving total pancreatectomy (DPSPTP) for end-staged chronic pancreatitis: 20 years' experience from a single pancreatic centre

Pancreatology ◽  
2016 ◽  
Vol 16 (3) ◽  
pp. S86-S87
Author(s):  
Andrea Sheel ◽  
Ryan Baron ◽  
Chris Halloran ◽  
Paula Ghaneh ◽  
Michael Raraty ◽  
...  
Keyword(s):  
Chronic Pancreatitis ◽  
Total Pancreatectomy ◽  
Spleen Preserving
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