scholarly journals A clinical study on lateral pancreaticojejunostomy in a case of chronic pancreatitis

2021 ◽  
Vol 8 (5) ◽  
pp. 1617
Author(s):  
Suhas B. Manapure ◽  
Anil S. Munde ◽  
Ravibhushan J. Kasale ◽  
Pramod Lokare
Keyword(s):  
Quality Of Life ◽  
Chronic Pancreatitis ◽  
Pain Relief ◽  
Pancreatic Duct ◽  
Anastomotic Leak ◽  
Pancreatic Insufficiency ◽  
Drainage Procedure ◽  
Health Care Centre ◽  
Lateral Pancreaticojejunostomy

Lateral pancreaticojejunostomy is a seldom performed procedure in a peripheral tertiary health care centre. Very few numbers of cases are reported that undergoes surgical procedures for chronic pancreatitis. We report a such rare case in our institute that undergone pancreatic drainage procedure. A 70 year old poor patient was admitted in our institute with a complaint of chronic abdominal pain, subsequently diagnosed to be having chronic pancreatitis with complications with pancreatic duct calculus. Pancreatic drainage procedure, lateral pancreaticojejunostomy was performed and we analysed for the outcome of the procedure with regards to pain relief, anastomotic leak, quality of life and return to work. Patient recovered well post-operatively, reported pain relief, suffered no anastomotic leak and experienced improved quality of life. Lateral pancreaticojejunostomy provides excellent surgical choice for patients of chronic pancreatitis with pancreatic duct calculus with acceptable rates of pain relief, morbidity and mortality, without worsening pancreatic insufficiency. 

scholarly journals Outcome of Pancreatic Head Coring in as Key Surgical Treatment in Head Dominant Chronic Pancreatitis in Tertiary Referral Centers of Bangladesh

2018 ◽  
Vol 8 (2) ◽  
pp. 151-158
Author(s):  
Hashim Rabbi ◽  
Md Mamunur Rashid ◽  
AHM Tanvir Ahmed ◽  
HM Sabbir Raihan ◽  
Sarder Rizwan Nayeem ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Chronic Pancreatitis ◽  
Pancreatic Duct ◽  
Pancreatic Head ◽  
Endocrine Function ◽  
Intractable Pain ◽  
Frey’S Procedure ◽  
Management Protocol ◽  
Lateral Pancreaticojejunostomy

Background: Pancreatic head coring procedure, an organ preserving surgery in which diseased head of pancreas is cored with drainage of main pancreatic duct by lateral pancreatico-jejunostomy. Chronic pancreatitis is a persistently occurring inflammatory disease that causes pancreatic duct stones or calcification, stricture, dilatation of pancreatic duct and irreversible morphological changes resulting intractable pain and losses of exocrine and endocrine function. Appropriate management protocol recognizing underlying pathology, can prevent complications and improves the quality of life. Apart from ductal decompression, in Frey’s’ procedure resection of the “pacemaker of pain” (Head of the pancreas) gives excellent outcome.Methods: In this prospective observational study, we have intended to further validate the Frey’s procedure an effective surgical method in head dominant severe chronic pancreatitis. The study was carried out on 106 Bangladeshi patients who underwent Frey’s Procedure with Lateral Pancreaticojejunostomy from January 2000 to December 2017.Result: The study revealed 51 patients (48.11%) were in 3rd decade of life with 45 male and 61 female. We found 77 patients presented with diabetes mellitus, mostly on insulin. Steatorrhoea was noted in 39 patients and Malnutrition in 79 patients. Visual Analog Scale (VAS) was used for scoring pain. Postoperative morbidity was noted in 29 patients 27.35 % cases, but there was no anastomotic leakage or mortality in the immediate postoperative period in our series.Conclusion: Quality of life has always been the most important decisive factor for patients with severe chronic Pancreatitis. Pain is the predominant clinical feature and very difficult to control. Correction of diabetes and malnutrition are major challenges too. This study revealed, Frey’s procedure with adequate ductal clearance with wide pancreato-jejunal anastomosis in head dominant severe chronic pancreatitis is key to better pain control, improves quality of life and prevents recurrence.Birdem Med J 2018; 8(2): 151-158

scholarly journals Diagnosis of the Pancreatic Functional Insufficiency

2021 ◽  
Vol 17 (4) ◽  
pp. 52-61
Author(s):  
M.V. Malykh ◽  
◽  
E.A. Dubtsova ◽  
L.V. Vinokurova ◽  
M.A. Kiryukova ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Overall Survival ◽  
Chronic Pancreatitis ◽  
Pancreatic Insufficiency ◽  
Diagnostic Methods ◽  
Adequate Treatment ◽  
Pancreatic Diseases ◽  
Diagnostic Role ◽  
Sensitivity Specificity

Exo- and/or endocrine pancreatic insufficiency are the complications and diagnostic criteria of chronic pancreatitis. Recently expanded surgical activity in pancreatic diseases prolongs overall survival in such patients. However, patients’ quality of life decreases due to exo- and endocrine pancreatic insufficiency. Timely diagnosis and adequate treatment of the conditions are based on the lab assessment of pancreatic function. The paper presents diagnostic methods, their sensitivity, specificity, and diagnostic role.

Prevalence of exocrine pancreatic insufficiency in patients with chronic pancreatitis without follow-up: Nutritional status and quality of life. PANCR-EVOL study

Pancreatology ◽  
2016 ◽  
Vol 16 (3) ◽  
pp. S68-S69
Author(s):  
Marra-Lopez Valenciano Carlos ◽  
Marín Serrano Eva ◽  
Bolado Concejo Federico ◽  
Francisco González María ◽  
Martínez-Moneo Emma ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Chronic Pancreatitis ◽  
Nutritional Status ◽  
Pancreatic Insufficiency ◽  
Exocrine Pancreatic Insufficiency

Long-term Outcomes Favor Duodenum-preserving Pancreatic Head Resection over Pylorus-preserving Pancreaticoduodenectomy for Chronic Pancreatitis: A Meta-analysis and Systematic Review

2015 ◽  
Vol 81 (9) ◽  
pp. 909-914 ◽  
Author(s):  
Prashant B. Sukharamwala ◽  
Krishen D. Patel ◽  
Anthony F. Teta ◽  
Shailraj Parikh ◽  
Sharona B. Ross ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Chronic Pancreatitis ◽  
Pain Relief ◽  
Pancreatic Head ◽  
Long Term Outcomes ◽  
Perioperative Morbidity ◽  
Endocrine Insufficiency ◽  
Significant Difference

Pylorus-preserving pancreaticoduodenectomy (PPPD) and duodenum-preserving pancreatic head resection (DPPHR) are important treatment options for patients with chronic pancreatitis. This meta-analysis was undertaken to compare the long-term outcomes of DPPHR versus PPPD in patients with chronic pancreatitis. A systematic literature search was conducted using Embase, MEDLINE, Cochrane, and PubMed databases on all studies published between January 1991 and January 2013 reporting intermediate and long-term outcomes after DPPHR and PPPD for chronic pancreatitis. Long-term outcomes of interest were complete pain relief, quality of life, professional rehabilitation, exocrine insufficiency, and endocrine insufficiency. Other outcomes of interest included perioperative morbidity and length of stay (LOS). Ten studies were included comprising of 569 patients. There was no significant difference in complete pain relief ( P = 0.24), endocrine insufficiency ( P = 0.15), and perioperative morbidity ( P = 0.13) between DPPHR and PPPD. However, quality of life ( P < 0.00001), professional rehabilitation ( P = 0.004), exocrine insufficiency ( P = 0.005), and LOS ( P = 0.00001) were significantly better for patients undergoing DPPHR compared with PPPD. In conclusion, there is no significant difference in endocrine insufficiency, postoperative pain relief, and perioperative morbidity for patients undergoing DPPHR versus PPPD. Improved intermediate and long-term outcomes including LOS, quality of life, professional rehabilitation, and preservation of exocrine function make DPPHR a more favorable approach than PPPD for patients with chronic pancreatitis.

scholarly journals The role of extracorporeal shock wave lithotripsy in the treatment of chronic pancreatitis

2021 ◽  
Vol 84 (4) ◽  
pp. 620-626
Author(s):  
D Geusens ◽  
H van Malenstein
Keyword(s):  
Quality Of Life ◽  
Shock Wave ◽  
Chronic Pancreatitis ◽  
Pancreatic Duct ◽  
Extracorporeal Shock Wave Lithotripsy ◽  
Main Pancreatic Duct ◽  
Shock Wave Lithotripsy ◽  
Extracorporeal Shock Wave ◽  
Pancreatic Duct Stones

Pain is the most frequent symptom in chronic pancreatitis (CP) and has an important impact on quality of life. One of its major pathophysiological mechanisms is ductal hypertension, caused by main pancreatic duct stones and/or strictures. In this article, we focus on extracorporeal shock wave lithotripsy (ESWL) as a treatment for main pancreatic duct stones, which have been reported in >50% of CP patients. ESWL uses acoustic pulses to generate compressive stress on the stones, resulting in their gradual fragmentation. In patients with radiopaque obstructive main pancreatic duct (MPD) stones larger than 5 mm, located in the pancreas head or body, ESWL improves ductal clearance, thereby relieving pain and improving quality of life. In case of insufficient ductal clearance or the presence of an MPD stricture, ESWL can be followed by endoscopic retrograde cholangiopancreatography (ERCP) to increase success rate. Alternatively, direct pancreaticoscopy with intracorporeal lithotripsy or surgery can be performed

scholarly journals Evidence-based pancreatology: what do we know about chronic pancreatitis by 2020?

2020 ◽  
Vol 47 (2) ◽  
pp. 19-31
Author(s):  
N. B. Gubergrits ◽  
N. V. Byelyayeva ◽  
G. M. Lukashevich ◽  
P. G. Fomenko ◽  
E. V. Berezhnaya ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Chronic Pancreatitis ◽  
Pancreatic Insufficiency ◽  
Pancreatic Enzyme ◽  
Clinical Manifestations ◽  
Genetic Mutations ◽  
Enzyme Preparations ◽  
Enzyme Replacement ◽  
Pancreatic Steatosis

The article reveals the achievements of modern pancreatology in the field of pathogenesis, dynamics of development and treatment of chronic pancreatitis (CP). Data of genetic studies describing the most diverse genetic mutations predisposing to the appearance of CP are considered. Genetic mutations causing not only СP, but also pancreatic cancer are analyzed. Risk factors of autoimmune pancreatitis development are mentioned; features of accompanying kidney affection are described. СP conceptual model including the phase of early СP is presented. The provisions of the International Consensus on Early CP are given, the criteria for diagnosing this stage of СP using both clinical/functional criteria and visualizing research methods are listed. Pathophysiological features of pancreatic fibrogenesis are considered. The results of studies describing the peculiarities of the appearance of exocrine pancreatic insufficiency (EPI), the feasibility of determining fecal elastase-1 as a screening of EPI are analyzed. Peculiarities of EPI occurrence in osteopenia, cardiovascular disease are considered. The nuances of pancreatic enzyme replacement therapy (PERT) in the pancreatic steatosis, obesity are described, as well as its impact on the quality of life of patients with CP and EPI. Advantages of using the enteric-coated minimicrospheres and possibility of controlling the clinical manifestations of EPI, increasing body weight, improving quality of life and its duration of PERT are listed. Optimal doses of enzyme preparations during PERT are considered, results of randomized studies proving the efficacy of minimicrospherical preparations are given.

scholarly journals Quality of life assessment in patients treated with chronic pancreatitis

2021 ◽  
pp. 54-54
Author(s):  
Sasa Dragovic ◽  
Maja Vulovic ◽  
Dusica Stamenkovic ◽  
Nemanja Rancic ◽  
Miroslav Mitrovic ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Chronic Pancreatitis ◽  
Surgical Treatment ◽  
Surgical Approach ◽  
Pancreatic Insufficiency ◽  
Life Assessment ◽  
Quality Of Life Assessment ◽  
Female Ratio ◽  
Euroqol 5D

Introduction. Chronic pancreatitis (CP) causes inflammatory changes in the tissue of the pancreas, resulting in irreversible tissue damage. Pain, endocrine, and exocrine pancreatic insufficiency develop, thereby reducing the quality of life of patients. The study aims to explore the role of surgical treatment in improving the quality of life of patients with CP. Methods. Quality of life assessment of 50 patients diagnosed with CP was performed using a certified Euro Quality of life-5 dimension-5 level questionnaire translated into Serbian (EuroQol-5D-5L). Patients completed the questionnaire. Patients were divided into two groups (conservative - CT vs. surgical - ST), and all comparations was made between groups. Results. Patients in stage B chronic pancreatitis were divided into two groups of 25 patients. The first group of patients with CP was treated with conservative, and the second group with surgical approach. Mane age in surgically treated (ST) group was 48.56 ? 11.91, and in conservatively treated (CT) group was 51.08 ? 11.61 (p=0.452). Male/female ratio in ST group was 18/7, and in CT group was 22/3 (p=0.289). Pain in ST group was present in 23 patients, and in CT group was present in 18 patients (p=0.141). Loss of appetite in ST group was present in 7 patients, and in CT group was present in 10 patients (p=0.256). Weight loss in both groups was equal (p=1.000). Based on EuroQol-5D-5L it was found significant differences (p<0.001) between group in Mobility and Pain / Discomfort; in Anxiety / Depression (p=0.003); in Self-care (p=0.004); in Usual activities (p=0.008). Conclusion. CP significantly reduce the quality of life (QoL) of patients treated conservatively or by surgical approach. This study showed that surgical treatment is more beneficial in QoL in patients with CP then conservative approach

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