Lateral Pancreaticojejunostomy for Pain Relief in Chronic Pancreatitis: Analysis of Effectiveness in 19 Patients

Escallón, Alberto; Js, Aldrete

doi:10.1097/00007611-198608000-00005

Cited by 4 publications

(1 citation statement)

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“…2). When the main pancreatic duct is opened for only a few centimeters in the neck, body, or tail of the pancreas [33, 39], or when only the tail of the pancreas is decompressed (e.g., Duval procedure [26]), or the ampullary sphincter is divided [43], only 30% to 40% of patients obtain pain relief.…”

Section: Pain Reliefmentioning

confidence: 99%

Comparison of Local Resection of the Head of the Pancreas Combined with Longitudinal Pancreaticojejunostomy (Frey Procedure) and Duodenum‐Preserving Resection of the Pancreatic Head (Beger Procedure)

Frey

Mayer

2003

World j. surg.

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The etiology of pain in chronic pancreatitis may be ductal hypertension, increased parenchymal pressure, or neural damage. It is difficult to assess the severity of pain in this patient population, a problem made more challenging by the frequency of narcotic dependency. Therapeutic interventions developed to relieve the pain of chronic pancreatitis include denervation of the pancreas, decompression of the main duct of the pancreas, resection of part or all of the diseased pancreas, and reduction of pancreatic secretion. Operative intervention for patients with chronic pain is indicated when severe pain, complications of pain, or potential malignancy are present. The operations that consistently provide long‐lasting pain relief all have in common resection of all or a portion of the head of the pancreas. Adverse effects on exocrine and endocrine function, nutrition, and quality of life are related to the amount of pancreas resected. The ideal procedure should be easy to perform, have a low morbidity and mortality rate, provide long‐lasting pain relief, and not augment endocrine and exocrine insufficiency. No single operation fulfills this ideal. The local resection of the head of the pancreas combined with longitudinal pancreaticojejunostomy (LR‐LPJ) proposed by Frey and the duodenum‐preserving resection of the head of the pancreas (DPHR) proposed by Beger are discussed. The conceptualization, development, and technique of LR‐LPJ are discussed, and comparisons of patient outcomes are made with the outcomes of other procedures for chronic pancreatitis.

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Section: Pain Reliefmentioning

confidence: 99%

Comparison of Local Resection of the Head of the Pancreas Combined with Longitudinal Pancreaticojejunostomy (Frey Procedure) and Duodenum‐Preserving Resection of the Pancreatic Head (Beger Procedure)

Frey

Mayer

2003

World j. surg.

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Local resection of the head of the pancreas combined with longitudinal pancreaticojejunostomy

Frey

Amikura

1995

J Hep Bil Pancr Surg

106

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Local resection of the head of the pancreas combined with longitudinal pancreaticojejunostomy (LR-LPJ) was performed in 50 patients, and the results were reported at the American Surgical Association meeting in San Antonio, Texas, on April 8, 1994. The operation was not performed in patients whose ducts were less than 4.5mm in diameter. There were no operative deaths. Forty-seven patients were followed for an average of 37 months. Fortythree of the 50 patients were alcoholics. Pseudocysts were present in 50% of the patients. Thirty-five intraabdominal operations had previously been performed on 23 patients. Preoperatively, all patients underwent computed tomography. Endoscopic retrograde cholangiopancreatography was performed in 82% of patients and angiography in 64%.

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Pancreaticojejunostomy For Severe Symptomatic Chronic Pancreatitis

1991

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The role of operation, particularly pancreaticojejunostomy, in the treatment of abdominal pain from chronic pancreatitis is controversial, but relief of pancreatic duct obstruction may decrease the rate of pancreatic organ failure. Our results over 6 years in 13 carefully selected patients suggest that pancreatic drainage does relieve pain but is less effective in preventing pancreatic exocrine failure. Pain was the indication for operation in all patients.

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Lateral Pancreaticojejunostomy for Pain Relief in Chronic Pancreatitis: Analysis of Effectiveness in 19 Patients

Cited by 4 publications

References 0 publications

Comparison of Local Resection of the Head of the Pancreas Combined with Longitudinal Pancreaticojejunostomy (Frey Procedure) and Duodenum‐Preserving Resection of the Pancreatic Head (Beger Procedure)

Comparison of Local Resection of the Head of the Pancreas Combined with Longitudinal Pancreaticojejunostomy (Frey Procedure) and Duodenum‐Preserving Resection of the Pancreatic Head (Beger Procedure)

Local resection of the head of the pancreas combined with longitudinal pancreaticojejunostomy

Pancreaticojejunostomy For Severe Symptomatic Chronic Pancreatitis

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