The European journal of surgery = Acta chirurgica · 2002
Outcome of pancreaticojejunostomy after previous endoscopic stenting in patients with chronic pancreatitis.
Сравнительное исследованиеСтатьяНазвание и аннотация: Перевод пока не подготовлен
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Boerma Djemila, van Gulik Thomas M, Rauws Erik A J, Obertop Huug, Gouma Dirk J
Аннотация
OBJECTIVE: To assess whether previous endoscopic stenting of the pancreatic duct influences the outcome of subsequent pancreaticojejunostomy in chronic pancreatitis.
DESIGN: Retrospective analysis.
SETTING: University hospital, the Netherlands.
PATIENTS: 50 patients with chronic pancreatitis, 26 of whom had previously had stents inserted and 24 who had not.
INTERVENTIONS: A questionnaire was sent to each patient to evaluate long-term pain relief, readmissions during follow-up and subjective efficacy of the operation, and risk factors for recurrent pain were calculated.
MAIN OUTCOME MEASURES: Postoperative morbidity, pain relief and subjective efficacy.
RESULTS: Patients with stents were operated on later (after 60 months of symptoms) than those without (17 months). 5 (19%) and 2 (8%) patients developed complications. No patient died. Personal follow-up (median 27 months) was obtained in 41 of 44 available patients (93%). 36 patients (88%) felt that they had benefited from pancreaticojejunostomy. 13 of the 21 patients with stents (62%) and 11 of the 20 patients without stents (55%) reported pain at least monthly, but of these 24 patients 21 patients (88%) had less pain than preoperatively; 11 (22%) had pain daily. 13 patients were readmitted for a relapse of pancreatitis, 3 of whom required partial pancreatectomy. Previous endoscopic stenting of the pancreatic duct was not a risk factor for recurrent pain (p = 0.61).
CONCLUSION: Endoscopic stenting of the pancreatic duct may be done for patients with chronic pancreatitis without adverse effects on the outcome of subsequent pancreaticojejunostomy.
DESIGN: Retrospective analysis.
SETTING: University hospital, the Netherlands.
PATIENTS: 50 patients with chronic pancreatitis, 26 of whom had previously had stents inserted and 24 who had not.
INTERVENTIONS: A questionnaire was sent to each patient to evaluate long-term pain relief, readmissions during follow-up and subjective efficacy of the operation, and risk factors for recurrent pain were calculated.
MAIN OUTCOME MEASURES: Postoperative morbidity, pain relief and subjective efficacy.
RESULTS: Patients with stents were operated on later (after 60 months of symptoms) than those without (17 months). 5 (19%) and 2 (8%) patients developed complications. No patient died. Personal follow-up (median 27 months) was obtained in 41 of 44 available patients (93%). 36 patients (88%) felt that they had benefited from pancreaticojejunostomy. 13 of the 21 patients with stents (62%) and 11 of the 20 patients without stents (55%) reported pain at least monthly, but of these 24 patients 21 patients (88%) had less pain than preoperatively; 11 (22%) had pain daily. 13 patients were readmitted for a relapse of pancreatitis, 3 of whom required partial pancreatectomy. Previous endoscopic stenting of the pancreatic duct was not a risk factor for recurrent pain (p = 0.61).
CONCLUSION: Endoscopic stenting of the pancreatic duct may be done for patients with chronic pancreatitis without adverse effects on the outcome of subsequent pancreaticojejunostomy.