Changing trends in the minimally invasive surgery for chronic pancreatitis

Kalayarasan, Raja; Shukla, Ankit

doi:10.3748/wjg.v29.i14.2101

Cited by 7 publications

(4 citation statements)

References 105 publications

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“…In Minimally invasive procedures, Indocyanine green was used to identify the CBD and vascularity of duodenum (Fig. 2) [12]. PD was performed using the conventional method.…”

Section: Methodsmentioning

confidence: 99%

Hepatic steatosis after pancreatectomy: Does duodenum preservation mitigate the risk?

Azam,

Pottakkat

et al. 2024

Preprint

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Background: Hepatic steatosis is a potential cause of long-term morbidity in 20-40% of post-pancreatectomy patients. Various risk factors have been proposed for hepatic steatosis after pancreatectomy. The present study aims to compare the incidence of post-pancreatectomy hepatic steatosis in patients with and without duodenum-preserving surgeries. Methods: A prospective cohort study of patients who underwent pancreatectomy with or without duodenum preservation for benign and malignant pancreatic diseases between January 2019 and December 2022 was included. Patients who underwent distal and total pancreatectomy were excluded. CT criteria for hepatic steatosis were absolute liver attenuation of less than 40 Hounsfield units (HU) or the difference between mean splenic and liver attenuation of more than 10 HU. Demographic parameters, exocrine insufficiency, and hepatic steatosis in post-operative periods were compared between the two groups. Results: 40 patients who underwent PD for malignant or non-malignant diseases were compared with 40 who underwent duodenal preserving pancreatic head resection (DPPHR) for chronic pancreatitis. Around 35% of patients had post-operative exocrine pancreatic enzyme insufficiency (EPI) in the DPPHR group, and 15% had EPI in the PD group. The incidence of hepatic steatosis after a minimum follow-up after six months was 17.5% (7/40) in the DPPHR group and 37.5% (15/40) in the PD group. Duodenal resection was found to be a significant risk factor for developing hepatic steatosis (P-0.045), which also persisted after propensity score matching analysis. Conclusion: Duodenal resection surgeries have more association with hepatic steatosis compared to duodenal preserving pancreatic surgeries.

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“…In Minimally invasive procedures, Indocyanine green was used to identify the CBD and vascularity of duodenum (Fig. 2) [12]. PD was performed using the conventional method.…”

Section: Methodsmentioning

confidence: 99%

Hepatic steatosis after pancreatectomy: Does duodenum preservation mitigate the risk?

Azam,

Pottakkat

et al. 2024

Preprint

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“…Боль при ХП в среднем регистрируется в 85 % случаев [10,49,50] и является сложным многофакторным процессом. Одной из главных причин болевого синдрома является обструкция протоковой системы ПЖ с развитием внутрипротоковой гипертензии.…”

Section: результаты и обс уждениеunclassified

Surgical treament of chronic pancreatitis (literature review)

Morozov,

Rumyantsev,

Lobakov

et al. 2024

vmirvz

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Target. To summarize the available literature data on the methods of surgical treatment of chronic pancreatitis, evaluate their results, identify shortcomings and possible solutions.Materials and Methods. We conducted a literature review of scientific papers over the past 20 years, using the resources of the search engines PubMed, Cyberleninka and eLIBRARY, on the available methods of surgical treatment of chronic pancreatitis. For this meta-analysis, we used articles containing an evidence-based experimental and clinical base on issues related to long-term and immediate results of surgical treatment.Results and discussion. We analyzed the immediate and long-term results of the methods of surgical treatment of chronic pancreatitis. In almost all studies, resection-drainage methods made it possible to effectively stop the pain syndrome for a long time. However, exoand endocrine insufficiency in most cases persisted or progressed, regardless of the method used. Another disadvantage of the existing methods was the inability to stop bleeding from the area of pancreatojejunostomy in the early postoperative period, so mortality after the development of these complications ranged from 5 to 60%.Conclusion. Based on the results studied, we identified the following disadvantages of the known methods of surgical treatment of chronic pancreatitis: 1. A long loop of the small intestine, at least 70 cm, turned off from digestion, leading to a significant decrease in the length of the intestinal tube, and, accordingly, the area of absorption of food nutrients. 2. The features of the reconstructive stage of the operation do not provide the physiological flow of pancreatic secretion into the duodenum and, accordingly, the activation of enzymes, thereby turning off the duodenal phase of digestion. 3. Roux-enabled loop of the small intestine creates favorable conditions for the development of excessive bacterial growth. 4. Lack of endoscopic evaluation of the pancreas to stop bleeding in the early postoperative period. After analyzing the literature data, we came to the conclusion that the elimination of these shortcomings will improve the results of chronic pancreatitis treatment.

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“…Robotic techniques have been used in several CP-specific resections, such as DPPHR. While these findings suggest the viability of minimally invasive surgery in CP, no randomized controlled trials have been conducted, and any benefits over routine open surgery remain speculative[ 2 , 18 , 19 ]. Total pancreatectomy with islet autotransplantation in small duct disease has shown promising results[ 6 ].…”

Section: Surgical Interventionmentioning

confidence: 99%

Non-pharmacological pain palliation methods in chronic pancreatitis

Tez,

Şahingöz,

Martlı

2023

World J Clin Cases

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Chronic pancreatitis (CP) is a condition characterized by persistent and often severe pain resulting from the inflammatory disease of the pancreas. While pharmacological treatments play a significant role in palliative pain management, some patients require non-pharmacological methods. This review article focuses on non-pharmacological approaches used to alleviate pain in CP. The article examines non-pharmacological palliation options, including surgery, endoscopic approaches, neurostimulation techniques, acupuncture, and other alternative medicine methods. The effectiveness of each method is evaluated, taking into consideration patient compliance and side effects. Additionally, this article emphasizes the importance of personalized pain management in CP and underscores the need for a multidisciplinary approach. It aims to summarize the existing knowledge on the use of non-pharmacological palliation methods to improve the quality of life for patients with CP.

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Changing trends in the minimally invasive surgery for chronic pancreatitis

Cited by 7 publications

References 105 publications

Hepatic steatosis after pancreatectomy: Does duodenum preservation mitigate the risk?

Hepatic steatosis after pancreatectomy: Does duodenum preservation mitigate the risk?

Surgical treament of chronic pancreatitis (literature review)

Non-pharmacological pain palliation methods in chronic pancreatitis

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