Drainage procedure for pancreatolithiasis: re-examination of the pancreatic duct diameter standard

Guoyong Chen; Yu You; Hongxian Yan; Junchuang He; Jianping Gong; Sidong Wei

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자료유형: 학술저널

저자정보: Guoyong Chen (People’s Hospital of Henan University) Yu You (The Second Affiliated Hospital of Chongqing Medical University) Hongxian Yan (People’s Hospital of Henan University) Junchuang He (People’s Hospital of Henan University) Jianping Gong (The Second Affiliated Hospital of Chongqing Medical University) Sidong Wei (People’s Hospital of Henan University)

저널정보: 대한외과학회 Annals of Surgical Treatment and Research Annals of Surgical Treatment and Research Vol.98 No.4

발행연도: 2020.4

수록면: 190 - 198 (9page)

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Purpose: Pancreatic duct decompression relieves pancreatic duct stone (PDS)-associated abdominal pain, though a consensus indication for the drainage procedure of the main pancreatic duct (MPD) is lacking. Moreover, major prognostic factors for postsurgical long-term pain relief and recurrence are largely unknown.
Methods: The clinical outcomes of 65 consecutive PDS patients undergoing surgery from 2008–2012 with 3+ years of follow-up were assessed.
Results: At postsurgical follow-up (median, 4.5 years; range, 3–7 years; procedure: Partington, n = 32; Frey, n = 27; pancreatoduodenectomy, n = 3; distal pancreatectomy, n = 3), the early complication and complete stone clearance rates were 29.2% and 97%, respectively. Long-term, complete and partial pain relief were 93.9%, 83.1%, and 10.8%, respectively. The risk of pancreatic fistula was higher in the <8 mm group than in the >8 mm group (P < 0.05), and 80% of the pancreatic fistula cases occurred in the <8 mm group. A shorter pain duration (P = 0.007), smaller MPD diameter (P = 0.04), and lower Izbicki pain score (P < 0.001) predicted long-term pain relief. Pain recurrence after initial remission occurred in 5 patients and was only related to pain duration (P = 0.02). Stone recurrence and pancreatic exocrine functional and endocrine functional deterioration occurred in 2, 5, and 11 patients, respectively.
Conclusion: Surgery provides excellent stone clearance, long-term pain relief, and acceptable postoperative morbidity. Using 8 mm as the criterion for drainage surgery can minimize the postoperative pancreatic fistula risk. Individualized and timely surgical treatment may improve the effect of surgery.

#Abdominal pain #Drainage #Operative surgical procedures #Pancreatitis #Prognosis

참고문헌 (23)

참고문헌 신청

Yadav D / 2011 / Incidence, prevalence, and survival of chronic pancreatitis : a population-based study / Am J Gastroenterol 106:2192~2199

Garg PK / 2004 / Survey on chronic pancreatitis in the Asia-Pacific region / J Gastroenterol Hepatol 19:998~1004

Ketwaroo GA / 2015 / Approach to patients with suspected chronic pancreatitis : a comprehensive review / Pancreas 44:173~180

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Isaji S / 2010 / Has the Partington procedure for chronic pancreatitis become a thing of the past? A review of the evidence / J Hepatobiliary Pancreat Sci 17:763~769

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