Recurrent Hemorrhaging from Stomal Ulcers Following a Side to Side Longitudinal Pancreaticojejunostomy for Chronic Pancreatitis: Report of a Case

Aims/Objectives. The purpose of our research was studying of the reasons to increase head of the pancreas with a comparative estimation of morphological changes and outcomes of surgical treatment at patients by whom the local resection of the head of the pancreas with duodenum- preserving has been executed. Materials and methods. Results of the surgical treatment and morphological changes of 104 patients were studied: a local resection of the head of the pancreas with longitudinal pancreaticojejunostomy (LRHP+LPJ, n = 33), LRHP without LPJ (LRHP—LPJ' n = 36) and a local resection of the head and isthmus of the pancreas without LPJ (LRHIP—LPJ, n = 35). Results and discussion. In comparison groups has been revealed statistically significant distinction (Н = 17,357, df = 2, р = 0,002) on the sizes of the pancreas head. In their groups has been revealed statistically significant distinction in the sizes intrapancreatic pseudocysts in the pancreas head (Н = 8,912, df = 2, р = 0,012). The Spearman correlation (Spearman, p) had been found out statistically significant strong direct dependence between variables «the sizes of the pancreas head» and «the sizes intrapancreatic pseudocysts in the pancreas head «in comparison groups: LRHP+LPJ p = +0,73, р < 0,0001, LRHP-LPJ p = +0,78, р < 0,0001, LRHIP-LPJ p = +0,76, р < 0,0001. Between three groups of the patients by quantity of complications after operation were statistically significant (x2 = 10,644, df = 2, р = 0,005). In comparison groups has not been established distinctions on presence of the complications with focal or diffuse perilobular fibrosis — С < 0,200 or intralobular fibrosis — С < 0,265, and presence periductal fibrosis — С = 0,124. Conclusions. The sizes of the pancreas' head in the compared groups directly depend on the sizes intrapancreatic pseudocysts in the pancreas head. The probability of the complications' development after operation is not depended with focal or diffuse perilobular fibrosis or intralobular fibrosis and presence periductal fibrosis.

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Outcome after Lateral Pancreaticojejunostomy for Chronic Calcific Pancreatitis: A Short Term Prospective Study

Journal of Shaheed Suhrawardy Medical College ◽

10.3329/jssmc.v11i1.43172 ◽

2019 ◽

Vol 11 (1) ◽

pp. 13-16

Author(s):

Nadim Ahmed ◽

Akther Ahmed ◽

Md Lutfor Rahman ◽

Shoaeb Imtiaz Alam ◽

Farhad Uddin Ahmed ◽

...

Keyword(s):

Chronic Pancreatitis ◽

Symptomatic Relief ◽

Analgesic Requirement ◽

College Hospital ◽

Medical College ◽

Chronic Calcific Pancreatitis ◽

Lateral Pancreaticojejunostomy ◽

Acute Attacks ◽

Longitudinal Pancreaticojejunostomy ◽

Calcific Pancreatitis

Chronic pancreatitis is a fairly common condition with pain being the major symptom and longitudinal pancreaticojejunostomy (LPJ) is performed for symptomatic relief. The aim of the study is to assess the outcome of LPJ for chronic calcific pancreatitis and to evaluate the factors influencing relief of symptoms. A prospective observational study enrolling 28 patients was conducted in the department of surgery of Shaheed Suhrawardy Medical College Hospital from January 2018 to December 2018. This study involved identification of various risk factors related to chronic pancreatitis, pancreaticojejunostomy, early post-operative outcome and postoperative assessment of pain relief at 1 and 6 months from surgery. Pain was assessed using Visual analogue scale (VAS). In chronic pancreatitis, there is a significant relief of pain in post-LPJ; the degree of relief was less in the alcoholics than non-alcoholics (p=0.09) and in smokers. There was also reduction in analgesic requirement and frequency of acute attacks of pain. In chronic pancreatitis, there is a significant relief of pain in post-LPJ, although the degree of relief is less in the alcoholics and smokers. J Shaheed Suhrawardy Med Coll, June 2019, Vol.11(1); 13-16

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