[Role of remaining ductal cephalad obstruction on the results of lateral pancreaticojejunostomy in chronic pancreatitis]

Abstract

Aims: To report the results of a pancreaticojejunostomy in the treatment of chronic pancreatitis, and to assess the role of residual cephalic ductal obstruction in pain recurrence.

Methods: Thirty seven patients with painful chronic pancreatitis whose pancreatic duct diameter exceeded 6 mm were treated by lateral pancreaticojejunostomy and were retrospectively studied. Deobstruction of the cephalad portion of the main pancreatic duct was complete in 21 patients (group A), while residual obstruction was noted in 16 patients (group B).

Results: One patient died post-operatively (2.7%) and 6 patients underwent complications (16%) that were treated without reoperation. With a median follow-up of 52 months, 26 patients were pain free (70%). Pain recurrence occurred in 3 patients in group A (14%) who were treated medically, versus in 8 patients in group B (50%) of whom 4 needed iterative surgery. Ongoing alcoholic addiction did not influence pain recurrence, which onset significantly altered the weight increase observed after pancreaticojejunostomy.

Conclusion: Lateral pancreaticojejunostomy has a low morbidity rate and offers long lasting pain relief in 86% of patients whose cephalad main pancreatic duct is completely deobstructed.