scholarly journals “SPLIT” Pancreaticojejunostomy in the Surgical Treatment of Chronic Pancreatitis

HPB Surgery ◽  
1994 ◽  
Vol 8 (1) ◽  
pp. 9-12 ◽  
Author(s):  
W. Mulder ◽  
E. de Jong ◽  
T. M. van Gulik ◽  
L. Th. de Wit ◽  
D. J. van Leeuwen ◽  
...  
Keyword(s):  
Chronic Pancreatitis ◽  
Surgical Treatment ◽  
Pancreatic Duct ◽  
Long Term Results ◽  
Jejunal Loop

“Split” pancreaticojejunostomy is a procedure consisting of vertical transection of the pancreas and anastomosis of both sides of the cut pancreatic duct with an interposed, Roux-en-Y jejunal loop. In this paper we report the long term results of this procedure in the treatment of eight patients with chronic pancreatitis (CP).

Short- and Long-Term Results of Surgical Treatment for Chronic Pancreatitis: A Single-Center Retrospective Experience in Japan

2017 ◽  
Vol 152 (5) ◽  
pp. S1270
Author(s):  
Ippei Matsumoto ◽  
Takaaki Murase ◽  
Keiko Kamei ◽  
Kohei Kawaguchi ◽  
Masataka Matsumoto ◽  
...  
Keyword(s):  
Chronic Pancreatitis ◽  
Surgical Treatment ◽  
Long Term Results ◽  
Single Center ◽  
Short And Long Term

Multiple Stenting of Refractory Pancreatic Duct Strictures in Severe Chronic Pancreatitis: Long-term Results

Endoscopy ◽  
2006 ◽  
Vol 38 (03) ◽  
pp. 254-259 ◽  
Author(s):  
G. Costamagna ◽  
M. Bulajic ◽  
A. Tringali ◽  
M. Pandolfi ◽  
A. Gabbrielli ◽  
...  
Keyword(s):  
Chronic Pancreatitis ◽  
Pancreatic Duct ◽  
Long Term Results

scholarly journals Immediate and Long-Term Results of Original Methods of Longitudinal Pancreatojejunostomy With The Expansion of the Area of Pancreatojejunal Anastomosis

2020 ◽  
Vol 9 (1) ◽  
pp. 35-45
Author(s):  
A. R. Propp ◽  
E. N. Degovtsov ◽  
S. A. Nikulina
Keyword(s):  
Chronic Pancreatitis ◽  
Pancreatic Duct ◽  
Main Pancreatic Duct ◽  
Comparison Group ◽  
Pancreatic Head ◽  
Main Group ◽  
Long Term Results ◽  
Hospital Treatment ◽  
Enzyme Preparations

RELEVANCE. The dependency results of draining operations on the efficcacy of drainig of ductal system of the pancreas and adequate outflow of the pancreatic juce through anastomosis are undoubtful, therefore the development of new techniques of longitudinal pancreatojejunostomy (LPJ) extending area of anastomosis is an actual challenge.AIM OF STUDY. To compare the immediate and long-term results of longitudinal pancreatojejunostomy with the expansion of the area of anastomosis in patients with chronic pancreatitis.MATERIAL AND METHODS. We analysed immediate and long-term results of LPJ in 58 patients with chronic pancreatitis with impaired patency of the major pancreatic duct (MPD) without the head enlargement.RESULTS. All patients were divided into two groups: comparison group ( n=26, operated up to 2008 ) and main group (n=32, operated stumps during the MPD diastasis and posterior pancreatic surface (n=3) into anastomosis, with resection of the anterior pancreatic surface in the form of triangular fragments (n=11), with circulation of the small intestine loop during the recovery phase (n=19). The original LPJ in the study group of patients did not lengthened the surgery (160 [135, 185]) and intraoperative blood loss (265 [175, 340]). In the main group of patients there was no postoperative complications and fatal outcomes, but the average duration postoperative hospital treatment (18 [16; 20.5]) exceeded some data of foreign and domestic authors. Pain within 5 years after surgery in patients of the main group exceeded 26.6% and the appearance of diarrheal syndrome with dependance from reception of enzyme preparations was twice lower than in patients og the comparison group. According to questionnaire EORTC QLQ-C30, 5 years after surgery statistically significant differences between groups in terms of scales CF, NV, DY (p=0.03, 0.02, 0.006 respectively), indicating the advantage of intervention performed in the mail group.CONCLUSIONS. 1. An indication for longitudinal pancreatojejunostomy in chronic pancreatitis is impaired patency of the main pancreatic duct in the absence of an increase and inflammatory mass in the pancreatic head.2. The width of the main pancreatic duct is less than 5 mm and the presence of diastasis between its proximal and distal stumps with the posterior surface of the pancreas preserved, is not a reason for refusing longitudinal pancreatic jujunostomy in favor of the resection method.3. The expansion of pancreatojejunal anastomosis when performing longitudinal pancreatojejunostomy can improve the immediate and longterm results of surgical treatment for chronic pancreatitis.

Endoscopic Versus Surgical Treatment of Downstream Pancreatic Duct Stones in Chronic Pancreatitis

2011 ◽  
Vol 77 (11) ◽  
pp. 1531-1538 ◽  
Author(s):  
Jianguo Hong ◽  
Jian Wang ◽  
Alex M. Keleman ◽  
David K. Imagawa ◽  
Kesen Xu ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Pain Relief ◽  
Hospital Stay ◽  
Success Rate ◽  
Pancreatic Duct ◽  
Length Of Hospital Stay ◽  
Long Term Results ◽  
Stone Removal ◽  
Pancreatic Duct Stones

Pancreatic duct stone is thought not only to be the cause of abdominal pain but also to be a risk factor for pancreatic cancer. Several treatment options have been implemented in the treatment of pancreatic duct stones. Stone location is a critical factor in selecting treatment. We present the results of 27 endoscopic treatments and 35 surgical treatments performed in three hospitals at a single university between January 2000 and January 2005. The results were compared retrospectively in terms of success rate of stone removal, length of hospital stay, complications, pain relief, and changes of pancreatic functions. In our study, endoscopy resulted in a similar success rate of stone removal and short-term pain relief rate as the surgical approach and with a shorter length of hospital stay. However, the surgical group had a more favorable long-term clinical result, as well as a lower number of hospital readmissions at the 5-year follow-up point. Based on long-term results, surgical treatment is more effective than endoscopy.

scholarly journals Optimal time for surgical treatment of chronic pancreatitis or optimal surgery?

2021 ◽  
Vol 55 (3) ◽  
pp. 191-198
Author(s):  
V.G. Yareshko ◽  
Iu.O. Mikheiev ◽  
O.F. Shpylenko ◽  
O.M. Babii
Keyword(s):  
Quality Of Life ◽  
Chronic Pancreatitis ◽  
Surgical Treatment ◽  
Long Term Results ◽  
Early Surgery ◽  
Surgery Group ◽  
Sf 36 ◽  
Eortc Qlq

Background. The majority of studies on the surgical treatment of chronic pancreatitis (CP) compare treatment outcomes by the type of the procedure. However, some studies, especially systematic reviews and meta-analyses, indicate the equality of different surgeries by their long-term results. During last 5–9 years, several studies showed advantages of early surgery in chronic pancreatitis, within three years after symptoms onset. Objective: to analyze the short- and long-term results of surgical treatment for chronic pancreatitis regarding timing and, accordingly, the neglect of the disease. Materials and methods. Retrospective analysis of data of 147 patients from 2001 to 2020, the main intervention was surgery aimed at the main manifestations of CP, such as pancreatic ductal and/or parenchymal hypertension. Patients who suffered from CP symptoms 3 years or more were included in the control group (late surgery), and those who noted symptoms of CP for less than 3 years were included in the study group (early surgery). All patients completed the EORTC QLQ-30, SF-36 questionnaires, as well as the questionnaire developed by the study authors, via telephone or mail, or during the visit. Results. According to all scales of the SF-36 questionnaire, except for Physical functioning, the group of early surgery prevails over the group of late surgery. The early surgery group had the best average scores on all functional scales of the EORTC QLQ-30 questionnaire compared to the late surgery group, except for the Cognitive functioning. Of the symptomatic scales, the early surgery group had the best averages on Pain and Diarrhea. The average Health/Quality of life scale was significantly better in the early surgery group. Conclusions. The quality of life, pain control, pancreatic function in patients operated within 3 years from the onset of CP symptoms were better compared to those with longer disease duration, with the same short-term results. The duration of the disease is a major factor for the success of surgical treatment of chronic pancreatitis in terms of long-term results. The early surgery is effective approach to obtain better long-term outcomes in chronic pancreatitis.

Long-term follow-up after multiple plastic stenting for refractory pancreatic duct strictures in chronic pancreatitis

Endoscopy ◽  
2019 ◽  
Vol 51 (10) ◽  
pp. 930-935 ◽  
Author(s):  
Andrea Tringali ◽  
Vincenzo Bove ◽  
Salvatore F. Vadalà di Prampero ◽  
Ivo Boškoski ◽  
Pietro Familiari ◽  
...  
Keyword(s):  
Chronic Pancreatitis ◽  
Pancreatic Duct ◽  
Balloon Dilation ◽  
Long Term Results ◽  
Plastic Stents ◽  
Pancreatic Stent ◽  
Stent Removal ◽  
Stricture Recurrence

Abstract Background Dominant pancreatic duct strictures in chronic pancreatitis are often managed by endoscopic placement of a single plastic stent. Insertion of multiple plastic stents (MPS) has been proven to be effective in managing refractory strictures, but data are still limited. The aim of this study was to investigate the efficacy and long-term results of MPS to dilate pancreatic duct strictures in chronic pancreatitis. Methods 48 patients (34 men; mean age 44 years) with chronic pancreatitis and a single pancreatic stent through a refractory stricture in the pancreatic head underwent the following protocol: 1) removal of the single pancreatic stent; 2) balloon dilation of the stricture; 3) insertion of the maximum number of stents; 4) stent removal after 6 – 12 months. Results The median number of pancreatic plastic stents placed was 3 (diameter 7 – 11.5 Fr, length 3 – 7 cm). Five patients (10.4 %) had persistent strictures after MPS removal. During a mean follow-up of 9.5 years (0.3 – 15.5 years) after stent removal, 74.4 % (32/43) of the patients were asymptomatic, and 25.6 % (11/43) experienced pancreatitis recurrence or pancreatic type pain after a mean time of 26.4 months (8/43, 18.6 % underwent plug extraction without evidence of stricture recurrence; 3/43, 7.0 % had stricture recurrence). No major complications were recorded. Conclusion Endoscopic multiple plastic stenting of chronic pancreatitis-related pancreatic duct strictures showed satisfactory long-term results, with the option of re-treatment. This procedure can be considered an important therapeutic alternative for painful pancreatic duct strictures located in the head of the pancreas in the setting of chronic pancreatitis.

scholarly journals Сomparative analysis of outcomes of chronic pancreatitis surgical treatment

2021 ◽  
pp. 80-87
Author(s):  
N.Yu. Sled ◽  
◽  
O.N. Sled ◽  
N.V. Merzlikin ◽  
V.F. Tskhai ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Chronic Pancreatitis ◽  
Surgical Treatment ◽  
Pancreatic Head ◽  
Long Term Results ◽  
Pancreatic Cysts ◽  
Combined Resection ◽  
Sf 36

Aim of study. To compare short-term and long-term outcomes of surgical treatment for patients with chronic pancreatitis. Material and methods. In the period of 2002-2020, a total of 123 patients underwent surgery for treatment of complications associated with chronic pancreatitis. The patients were divided into three groups depending on the type of intervention. Patients in Group 1 underwent drainage (n=46), patients in Group 2 underwent resection (n=26) and patients in Group 3 combined resection and draining procedures (n=51). Results. After Roux-en-Y cystojejunostomy of cysts in distal parts of the pancreas(n=11), the amount of complications was lower (3 (27 [6; 61]%)) than after distal resection (n=20): 10 (50 [27; 73]%)), and the quality of life (SF-36) was higher in the long term (PSC: 55.75, MCS: 53.53 against PCS: 48.09, MCS – 49,72) after resection repair. The frequency of postoperative complications and lethality rate were higher in patients after different variants of sparing resection of pancreatic parenchyma with duct system drainage than in the group of patients treated with longitudinal cystojejunostomy. In the long term, lower lethality (5 [0; 23]%; p<0.05) and a higher level of physical (PCS – 61.31) and mental (MCS – 61.73) health were registered after the original variant of combined resection and draining intervention in comparison with traditional pancreatojejunostomy and duodenum-preserving surgery. Conclusion. Draining interventions on pancreatic cysts in distal parts of the pancreas is accompanied by better immediate and long-term results. Drainage without consideration for changes in the pancreatic head leads to a higher recurrence rate (27 [8; 55]%, р=0.013). Immediate results of the proposed combined resection and draining intervention are comparable with duodenum-preserving surgery but are characterised by lower mortality (5 [0; 23]%, р=0.06) and higher quality of life (SF-36) in the long term.

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