Functional and Medical Outcomes After Tailored Surgery for Pain Due to Chronic Pancreatitis

Gaag, Niels A. van der; Gulik, Thomas M. Van; Busch, Olivier R.; Sprangers, Mirjam A. G.; Bruno, Marco J.; Zevenbergen, Chantal; Gouma, Dirk J.; Boermeester, Marja A.

doi:10.1097/sla.0b013e31824b7697

Cited by 75 publications

(55 citation statements)

References 47 publications

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“…This is in accordance with previous studies, 39,40 and is further confirmed by a recent systematic review reporting a rate of 39% for newonset DM after distal pancreatectomy. 41 The relatively enriched distribution of islets in distal pancreas and the additional surgical resection based on pre-existing fibroinflammatory destruction of pancreatic parenchyma offer possible explanations.…”

Section: Discussionsupporting

confidence: 79%

Risk factors for diabetes mellitus in chronic pancreatitis: A cohort of 2,011 patients

Xin

2016

Pancreatology

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Section: Discussionsupporting

confidence: 79%

Risk factors for diabetes mellitus in chronic pancreatitis: A cohort of 2,011 patients

Xin

2016

Pancreatology

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“…The patients who most benefit from PD have low preopera tive pain levels, suggested by the lack of daily opioid use, few endoscopic procedures and have dilated ducts (8mm or greater). 50 If pain persists, celiac plexus block and pregabalin, or a complete pancreatectomy and islet cell autotransplanta tion should be considered. 51 Although low, patients with pancreatitis have an increased risk of developing pancreatic cancer.…”

Section: Chronic Pancreatitismentioning

confidence: 99%

Whipple procedure: patient selection and special considerations

Tan-Tam¹,

Segedi²,

Chung³

2016

OAS

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At the inception of pancreatic surgery by Dr Whipple in 1930s, the mortality and morbidity risk was more than 20%. With further understanding of disease processes and improve ments in pancreas resection techniques, the mortality risk has decreased to less than 5%. Age and chronic illnesses are no longer a contraindication to surgical treatment. Life expectancy and quality of life at a later age have improved, making older patients more likely to receive pancreatic surgery, thereby also putting emphasis on operative patient selection to minimize complica tions. This review summarizes the benign and malignant illnesses that are treated with pancreas operations, and innovations and improvements in pancreatic surgery and perioperative care, and describes the careful selection process for patients who would benefit from an operation. These indications are not reserved only to Whipple operation, but to pancreatectomies as well.

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“…A Roux-en-Y jejunal limb is sutured side-to-side to the pancreas [75]. The procedure is associated with low morbidity and mortality rates (about 1%) [20,21]. Immediate and lasting pain relief is reported in 80% (range 42-100%) of the patients with a follow-up of 62 (range 15-110) months [20].…”

Section: Surgical Therapymentioning

confidence: 99%

“…Recently, an expert center published their results of a large cohort of patients with CP who underwent surgery for CP. After a median period of 40 months (10-90th percentile; 12-132 months) after start of pain complaints and after a median of 2 (range 0-29) endoscopic procedures, patients were referred for surgery [21]. Other indications for surgery are a suspicion of neoplasm and local complications of adjacent organs, such as duodenal or common bile duct stenosis, pseudoaneurysm or erosion of the large vessels, large pancreatic pseudocysts, and internal pancreatic fistula.…”

Section: Surgical Therapymentioning

confidence: 99%

“…This approach can be questioned because evidence suggests that early intervention can mitigate the disease progression, achieve pain control, and preserve pancreatic function. The timing of surgery remains an important dilemma, as conclusive evidence is lacking [19,20,21]. In this review, we will discuss the endoscopic and surgical treatment options for patients with painful CP, in particular drainage of the PD (ductal decompression) and the timing of surgery.…”

Section: Introductionmentioning

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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Functional and Medical Outcomes After Tailored Surgery for Pain Due to Chronic Pancreatitis

Cited by 75 publications

References 47 publications

Risk factors for diabetes mellitus in chronic pancreatitis: A cohort of 2,011 patients

Risk factors for diabetes mellitus in chronic pancreatitis: A cohort of 2,011 patients

Whipple procedure: patient selection and special considerations

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

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