scholarly journals A hybrid approach for chronic pancreatitis: combination of laparoscopic assisted distal pancreatectomy and open Frey procedure

2021 ◽  
Author(s):  
Kenta Saito ◽  
Yoichi Matsuo ◽  
Goro Ueda ◽  
Kan Omi ◽  
Yuichi Hayashi ◽  
...  
Keyword(s):  
Chronic Pancreatitis ◽  
Surgical Treatment ◽  
Pancreatic Duct ◽  
Distal Pancreatectomy ◽  
Hybrid Approach ◽  
Laparoscopic Approach ◽  
Open Approach ◽  
Severe Stenosis ◽  
Frey Procedure ◽  
Minimal Invasiveness

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 laparoscopic approach by hybrid 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 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. There were no major intraoperative complications (Clavien-Dindo classification Ⅲa or more) 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 might be the optimal approach for the surgical treatment of chronic pancreatitis which requires a pancreatectomy with the Frey procedure.

scholarly journals A hybrid approach for chronic pancreatitis: combination of laparoscopic assisted distal pancreatectomy and open Frey procedure

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kenta Saito ◽  
Yoichi Matsuo ◽  
Goro Ueda ◽  
Kan Omi ◽  
Yuichi Hayashi ◽  
...  
Keyword(s):  
Chronic Pancreatitis ◽  
Surgical Treatment ◽  
Pancreatic Duct ◽  
Distal Pancreatectomy ◽  
Intraoperative Complications ◽  
Hybrid Approach ◽  
Open Approach ◽  
Severe Stenosis ◽  
Frey Procedure ◽  
Minimal Invasiveness

Abstract Background The treatment of chronic pancreatitis requires a surgical approach in patients who are 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. Indeed, suboptimal procedures lead to recurrent pancreatitis. We used a laparoscopic hybrid approach for patients with severe stenosis of the pancreatic duct. In this report, we present the feasibility and outcomes of our approach. Methods We selected a laparoscopic approach for the distal pancreatectomy, which is relatively safe and the effect of reducing the length of the wound is substantial. We selected an open approach for the Frey procedure because complete ductal compression has a high risk for injury to the vessels posterior to the pancreas. We recorded the operative outcomes, postoperative complications, and recurrence of pancreatitis. Results We performed the laparoscopic hybrid approach on 3patients between January and December 2018. There were no major intraoperative complications (Clavien-Dindo classification IIIa or more) and the postoperative course was uneventful in all patients. There were no recurrences of pancreatitis and no postoperative pain in all patients in > 2 years of follow-up. Conclusion Our hybrid method with a focus on complete ductal compression with safety and minimal invasiveness might be the optimal approach for the surgical treatment of chronic pancreatitis that requires a pancreatectomy with the Frey procedure.

scholarly journals A minimally invasive approach for chronic pancreatitis: combination of Frey procedure and laparoscopic distal pancreatectomy

2021 ◽  
Author(s):  
Kenta Saito ◽  
Yoichi Matsuo ◽  
Goro Ueda ◽  
Kan Omi ◽  
Yuichi Hayashi ◽  
...  
Keyword(s):  
Chronic Pancreatitis ◽  
Surgical Treatment ◽  
Minimally Invasive ◽  
Pancreatic Duct ◽  
Distal Pancreatectomy ◽  
Open Approach ◽  
Minimally Invasive Approach ◽  
Severe Stenosis ◽  
Invasive Approach ◽  
Frey Procedure

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.

scholarly journals A novel minimally invasive approach for chronic pancreatitis: combination of Frey procedure and laparoscopic distal pancreatectomy

2020 ◽  
Author(s):  
Kenta Saito ◽  
Yoichi Matsuo ◽  
Goro Ueda ◽  
Kan Omi ◽  
Yuichi Hayashi ◽  
...  
Keyword(s):  
Chronic Pancreatitis ◽  
Surgical Treatment ◽  
Minimally Invasive ◽  
Pancreatic Duct ◽  
Distal Pancreatectomy ◽  
Open Approach ◽  
Minimally Invasive Approach ◽  
Severe Stenosis ◽  
Invasive Approach ◽  
Frey Procedure

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 novel 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.

scholarly journals A novel minimally invasive approach for chronic pancreatitis: combination of Frey procedure and laparoscopic distal pancreatectomy

2020 ◽  
Author(s):  
Kenta Saito ◽  
Yoichi Matsuo ◽  
Goro Ueda ◽  
Kan Omi ◽  
Yuichi Hayashi ◽  
...  
Keyword(s):  
Chronic Pancreatitis ◽  
Surgical Treatment ◽  
Minimally Invasive ◽  
Pancreatic Duct ◽  
Distal Pancreatectomy ◽  
Open Approach ◽  
Minimally Invasive Approach ◽  
Severe Stenosis ◽  
Invasive Approach ◽  
Frey Procedure

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 novel 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 18 months 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.

scholarly journals Modern principles of surgical treatment of chronic pancreatitis

2019 ◽  
pp. 306-312
Author(s):  
Volodymyr Kopchak ◽  
Mykhailo Nychytailo ◽  
Oleksandr Duvalko ◽  
Vasyl Khanenko ◽  
Volodymyr Trachuk ◽  
...  
Keyword(s):  
Chronic Pancreatitis ◽  
Surgical Treatment ◽  
Pancreatic Duct ◽  
Surgical Techniques ◽  
Surgical Interventions ◽  
Distal Pancreatic Resection ◽  
Initial Surgery ◽  
Beger Procedure ◽  
Repeated Surgery ◽  
Resection Of The Pancreas

We reviewed the charts of 752 patients, who have undergone surgery for various forms of chronic pancreatitis at “Shalimov’s National Institute of Surgery and Transplantation of the NAMS of Ukraine” in the years from 2007 to 2017. The average age of the 591 males (78,6 %) and 161 females (22,4 %) was 43,0 ± 3,2 years. Out of these, 446 (62,4 %) patients with pseudocysts and pancreatic fistula and also with isolated main pancreatic duct lithiasis underwent drainage procedures. The 269 (37.6%) patients were subjected to different types of resection, including the Frey operation, pancreatoenterostomy with artificial pancreatic duct formation, the Berne technique, the Beger procedure, pancreatoduodenectomy, distal-pancreatic resection and other procedures. After pancreatic resections, the patients did not require repeated surgical interventions for chronic pancreatitis. In some cases of chronic pancreatitis, there was an isolated lesion of the pancreas: in such cases (13 patients), we performed distal resection of the pancreas. Among the observed patients here were no fatal cases. Satisfactory results were obtained in 92.6 % of cases at longterm follow-up. Post-operative complications occurred in 27 patients (4.6 %), in 6 (1.03 %) patients there was a need for repeated surgery. Progression of the disease in patients previously operated in our clinic was observed in 32 (5.5 %), and 72 patients, initially operated in other medical institutions. Patients after direct resection of the pancreas did not require repeated surgery for chronic pancreatitis. The main causes of unsatisfactory results of the surgical treatment for chronic pancreatitis have been found to be: false indications for initial surgery, improper primary surgical techniques, insufficient use of drainage procedures, as well as, performing a drainage procedure instead of a resection. Key words: chronic pancreatitis, surgical treatment, resection and drainage procedures. For citation: Usenko OY, Kopchak VM, Nychytailo MY, Duvalko OV, Khanenko VV, Trachuk VI, Khomiak AI. Modern principles of surgical treatment of chronic pancreatitis. Journal of the National Academy of Medical Sciences of Ukraine. 2019;25(3):306–12

The most recent recommendations for the surgical treatment of inguinal hernia

2019 ◽  
Vol 98 (7) ◽  
pp. 268-272
Keyword(s):  
Inguinal Hernia ◽  
Surgical Treatment ◽  
Hernia Repair ◽  
Mesh Repair ◽  
Laparoscopic Hernia Repair ◽  
Laparoscopic Approach ◽  
Safe Procedure ◽  
Recurrence Rates ◽  
Hernia Sac ◽  
Minimal Invasiveness

Introduction: The publication of new guidelines in recent years shows that surgical treatment of inguinal hernia remains topical. The main goal is to improve patient outcomes, specifically to decrease recurrence rates and reduce chronic pain. The main purpose of this article is to summarize the latest recommendations in surgical treatment of the groin hernias, especially in the case of strangulation. Methods: The authors made literature review of all the guidelines published by the hernia societies, including related articles, in the last ten years. Results: The use of the EHS classification system is suggested. In elective operations, mesh repair is recommended. The Lichtenstein technique is the standard in open inguinal hernia repair. Transabdominal preperitoneal and totally extraperitoneal approach have comparable outcomes. Their clear advantages include minimal invasiveness. Mesh repair is recommended also in the case of strangulation, but only in clean and clean-contaminated operations. A laparoscopic approach should be considered as well. Inter alia, it allows an assessment of bowel viability during the whole procedure. The need of bowel resection is hence lower compared to open surgery. If it is not possible to use the mesh, the Shouldice method is regarded as the best non-mesh repair technique. If there is concern about bowel viability, visualization, either by formal laparoscopy, hernia sac laparoscopy or laparotomy, is recommended. Hernioscopy is a simple and safe procedure that uses the hernia sac for insertion of a port following insufflation and diagnostic examination. It requires less advanced laparoscopic skills than does emergency laparoscopic hernia repair. It can be performed even by surgeons who lack sufficient experience with laparoscopy. Conclusion: In elective procedures, the mesh repair is recommended. It is recommended also in the case of strangulation, but not in a contaminated- dirty surgical field. If there is concern about bowel viability, visualization, either by formal laparoscopy, hernia sac laparoscopy or laparotomy, is needed.

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).

Chronic pancreatitis

2018 ◽  
pp. 379-386
Author(s):  
Abdullah Jibawi ◽  
Mohamed Baguneid ◽  
Arnab Bhowmick
Keyword(s):  
Chronic Pancreatitis ◽  
Pain Management ◽  
Ct Scan ◽  
Pancreatic Duct ◽  
Distal Pancreatectomy ◽  
Multidisciplinary Approach ◽  
Laparoscopic Distal Pancreatectomy ◽  
Accurate Diagnosis ◽  
Nerve Plexus

Management of chronic pancreatitis requires a multidisciplinary approach. Accurate diagnosis can be challenging, as initial tests may be inconclusive. MRCP/ERCP and CT scan are used in diagnosis. A plan for stepwise pain management is discussed including nerve plexus blocks. Therapy may involve endoscopic pancreatic duct decompression, and a small number may benefit from surgery such as pancreatectomy and pancreatico-jejunostomy or laparoscopic distal pancreatectomy

Sign in / Sign up

Export Citation Format

Share Document