Effect of surgery for chronic pancreatitis on pancreatic function: pancreatico-jejunostomy and duodenum-preserving resection of the head of the pancreas

Maartense, S.; Ledeboer, M.; Bemelman, Willem A.; Ringers, J.; Frölich, M.; Masclee, Ad

doi:10.1016/j.surg.2003.09.004

Cited by 45 publications

(35 citation statements)

References 25 publications

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“…Surgery can impair pancreatic function. Pancreatic exocrine insufficiency (PEI) develops in patients following pancreatoduodenectomy and pylorus-preserving pancreatoduodenectomy [86,103]. PEI is found in most patients after partial pancreatic resection as well as in patients with chronic pancreatitis [86,104].…”

Section: C7mentioning

confidence: 99%

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Italian consensus guidelines for chronic pancreatitis

Frulloni

Falconi

Gabbrielli

et al. 2010

Digestive and Liver Disease

166

112

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This paper gives practical guidelines for diagnosis and treatment of chronic pancreatitis. Statements have been elaborated by working teams of experts, by searching for and analysing the literature, and submitted to a consensus process by using a Delphi modified procedure. The statements report recommendations on clinical and nutritional approach, assessment of pancreatic function, treatment of exocrine pancreatic failure and of secondary diabetes, treatment of pain and prevention of painful relapses. Moreover, the role of endoscopy in approaching pancreatic pain, pancreatic stones, duct narrowing and dilation, and complications was considered. Recommendations for most appropriate use of various imaging techniques and of ultrasound endoscopy are reported. Finally, a group of recommendations are addressed to the surgical treatment, with definition of right indications, timing, most appropriate procedures and techniques in different clinical conditions and targets, and clinical and functional outcomes following surgery. © 2010 Editrice Gastroenterologica Italiana S.r.l

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Section: C7mentioning

confidence: 99%

“…Moreover it is associated with low mortality and morbidity rates [276][277][278]. In a prospective study, Maartense [103] compared DPHR vs. LPJ and observed an improvement of endocrine function after LPJ. However, LPJ has not been evaluated in RCTs, even if it is widely used.…”

Section: S7mentioning

confidence: 99%

Italian consensus guidelines for chronic pancreatitis

Frulloni

Falconi

Gabbrielli

et al. 2010

Digestive and Liver Disease

166

112

View full text Add to dashboard Cite

show abstract

“…Several studies have shown that pancreatic exocrine function improved after endoscopic treatment, while endocrine function remained largely unaffected [31,32,35,42]. On the contrary, Maartense et al [48 ]showed that surgery for CP did not influence the exocrine pancreatic function after either drainage or resection procedure. Clinical endocrine function was not affected after resection procedure but improved after drainage procedure [48].…”

Section: Endoscopic Therapymentioning

confidence: 99%

“…On the contrary, Maartense et al [48 ]showed that surgery for CP did not influence the exocrine pancreatic function after either drainage or resection procedure. Clinical endocrine function was not affected after resection procedure but improved after drainage procedure [48]. …”

Section: Endoscopic Therapymentioning

confidence: 99%

“…Piglets undergoing PD ligation and subsequent longitudinal pancreaticojejunostomy show improved histology and pancreatic exocrine function when early surgical drainage is performed versus late drainage [145]. Clinical studies reported stabilization and postponement of both endocrine and exocrine insufficiency after surgical drainage procedures [48,76,146]. …”

Section: Future Challenges: Timing Of Surgerymentioning

confidence: 99%

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Surgical and Endoscopic Treatment of Pain in Chronic Pancreatitis: A Multidisciplinary Update

et al. 2013

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Chronic pancreatitis is an inflammatory disease of the pancreas with abdominal pain as the most prominent symptom. Adequate treatment of patients with chronic pancreatitis remains a major challenge, mainly because of the lack of evidence-based treatment protocols. The primary goal of treatment is to achieve long-term pain relief, control of the complications associated with the disease, and to restore the quality of life. Currently, a conservative step-up approach is often used for the treatment of pain; progression to severe and intractable pain is considered necessary before invasive treatment is considered. Recent studies, however, suggest that surgical intervention should not be considered only as last-resort treatment, since it can mitigate disease progression, achieve excellent pain control, and preserve pancreatic function. In this review, we present a state-of-the art overview of endoscopic and surgical treatment options for patients with painful chronic pancreatitis, and elaborate on the timing of surgery.

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