Abstract
Background: The treatment of chronic pancreatitis requires a surgical approach in patients refractory to medical therapy. During surgical treatment, ductal decompression is required, but a pancreatectomy is necessary for some patients, such as those with severe stenosis of the pancreatic duct. Importantly, inadequate procedures lead to recurrent pancreatitis. We used a minimally invasive approach for patients with severe stenosis of the pancreatic duct. In this report, we aim to present the feasibility and outcomes of our approach. Methods: We selected a laparoscopic approach for the distal pancreatectomy because these parts are relatively safe and the effect of reducing the length of the wound is substantial. We selected an open approach for parts of the Frey procedure because complete ductal compression has a high risk for injury to the vessels posterior to the pancreas. We examined operative outcomes, postoperative complications and recurrence of pancreatitis.Results: Our approach was performed in three patients from January 2018 to December 2018. No intraoperative complications occurred and the postoperative course was uneventful in all patients. There were no recurrence of pancreatitis and no postoperative pain in all patients in the over two years follow-up. Conclusion: Our hybrid method focusing on complete ductal compression with safety and minimal invasiveness is the optimal approach for the surgical treatment of chronic pancreatitis which requires a pancreatectomy with the Frey procedure.
Minimally invasive approach in the open heart surgical treatment of atrial fibrillation
