Comparative study of surgical management of chronic pancreatitis

Authors

  • Vinaya Ambore Department of Surgery, Grant Government Medical College, Mumbai, Maharashtra, India
  • Vismaya K. B. Department of Surgery, Grant Government Medical College, Mumbai, Maharashtra, India
  • Rihan Rashid Department of Surgery, Grant Government Medical College, Mumbai, Maharashtra, India

DOI:

https://doi.org/10.18203/2349-2902.isj20233675

Keywords:

Chronic pancreatitis, Surgical treatment, Laparoscopic pancreatojejunostomy

Abstract

Background: Chronic pancreatitis is a chronic inflammatory disease, characterised by irreversible, progressive destruction of pancreatic tissue, with progressive fibrosis of pancreas, leading to progressive loss of both exocrine and endocrine function. Chronic pancreatitis is characterised by the patient complaining of relentless pain abdomen with its radiation to the back, the history of persistent vomiting, which forces the patient to take. The surgical procedure can be carried out either via open approach or laparoscopically. The purpose of this thesis is to study the various methods of how surgical management can be provided to the patients and to compare the outcomes of these methods in terms of the length of the patient’s hospital stays and various intra op and post op complications.

Methods: A total of 50 patients suffering from chronic pancreatitis undergoing elective pancreaticojejunostomy in Grant government medical college, Mumbai during the time period of October 2020 to September 2022 were included in this prospective cohort study.

Results: The mean age of the study population was 36.6 years, and significant improvement was seen in laparoscopic method with mean blood loss of 104 ml, initiation of enteral nutrition of 4 days and average length of hospital stay being 8 days.

Conclusions: This work significantly advances our understanding of various operative techniques of pancreatojejunostomy laparoscopic and open. This study aims to study the various advantages and disadvantages of one technique over the other.

References

Khan AS, Siddiqui I, Vrochides D, Martinie JB. Robotic pancreas drainage procedure for chronic pancreatitis: Robotic lateral pancreaticojejunostomy (Puestow procedure). J Vis Surg. 2018;4:72.

Kirks RC, Lorimer PD, Fruscione M, Cochran A, Baker EH, Iannitti DA, et al. Robotic longitudinal pancreaticojejunostomy for chronic pancreatitis: Comparison of clinical outcomes and cost to the Open Approach. Int J Med Robot. 2017;13(3):231-9.

Ramia JM, Azagra JS, De la Plaza R, Manuel A, Latorre R, Lopez-Marcano A. Laparoscopic longitudinal pancreaticojejunostomy for chronic pancreatitis. Surgeon. 2020;18:137-41.

Nealon WH, Townsend CM, Thompson JC. Operative drainage of the pancreatic duct delays functional impairment in patients with chronic pancreatitis. A prospective analysis. Ann Surg. 1988;208:321-9.

Senthilnathan P, Babu S, Vikram A, Sabnis SC, Gurumurthy SS, Vijay NA, et al. Laparoscopic longitudinal pancreaticojejunostomy and modified frey's operation for chronic calcific pancreatitis. BJS. 2019;3:666-71.

Tantia M, Matsumoto I, Shinzeki M, Asari S, Goto T, Hironori Y, et al. Short and long term results of modified frey's procedurein patients with chronic pancreatitis: A retrospective Japanese single center study. Kobe J Med Sci. 2014;60:E30-6.

Palanivelu C, Shetty R, Jani K, Rajan PS, Sendhilkumar K, Parthasarthi R, et al. Laparoscopic lateral pancreaticojejunostomy: A new remedy for an old ailment. Surg Endosc. 2006;20:458-6.

Adolff M, Schlogel M, Arnauld JP. Ollier JC. Role of pancreaticojejunostomy in the treatment of chronic pancreatitis: Study of 105 operated patients. Chirugie. 1991;117:251-57.

Sielezneff I, Malouf A, Salle E, Brunet C, Thirion X, Sastre B. Long term results of lateral pancreaticojejunostomy for chronic alcoholic pancreatitis. Eur J Surg. 2000;166:58-64.

Schnelldorfer T, Lewin DN, Adams DB. Operative management of chronic pancreatitis: Long term results in 372 patients. J Am Coll Surg. 2007;204: 2039-45.

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Published

2023-11-28

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Section

Original Research Articles