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‘Short’pancreaticojejunostomy might be a valid option for treatment of chronic pancreatitis in many cases

World Journal of Gastrointestinal Surgery 2021年第12期13卷 1673-1684页

作者： Marko Murruste Ülle Kirsimägi Karri Kase Tatjana Veršinina Peep Talving Urmas Lepner Department of Surgery Tartu University HospitalTartu 50406Estonia Faculty of Medicine University of TartuTartu 50411Estonia Division of Acute Care Surgery Department of SurgeryNorth-Estonia Medical CentreTallinn 13419Estonia

BACKGROUND The Partington-Rochelle pancreaticojejunostomy(PJ)is an essential management option for patients with chronic pancreatitis(CP)associated with intractable pain and a dilated pancreatic duct(PD).Wide ductotomy and long PJ(L-PJ)have been advocated as the standard of care to ensure full PD ***,the role of short PJ(S-PJ)in a uniformly dilated PD has not yet been *** To evaluate the possible advantages and disadvantages of S-PJ and L-PJ and to interpret the perspective of S-PJ in the treatment of *** A retrospective review of prospectively collected cohort data was conducted on surgically treated CP patients subjected to side-to-side *** length of the PJ was adapted to anatomical alterations in PD.A comparison was made of S-PJ(<50 mm)for uniformly dilated PD and L-PJ(50-100 mm)in the setting of multiple PD strictures,calcifications and *** hypothesized that S-PJ and L-PJ ensure comparable clinical *** primary outcomes were pain relief and quality of life(QOL);the secondary outcomes were perioperative characteristics,body weight,patients’satisfaction with treatment,and readmission rate due to *** Overall,91 patients underwent side-to-side PJ for CP,including S-PJ in 46 patients and L-PJ in 45 patients.S-PJ resulted in better perioperative outcomes:Significantly shorter operative time(107.5 min vs 134 min),lower need for intraoperative(0%vs 15.6%)and total(2.2%vs 31.1%)blood transfusions,and lower rate of perioperative complications(6.5%vs 17.8%).We noted no significant difference in pain relief,improvement in QOL,body weight gain,patients’satisfaction with surgical treatment,or readmission rate due to *** Based on our data,in the setting of a uniformly dilated PD,S-PJ provides adequate decompression of the *** the clinical outcomes following S-PJ are not inferior to those of L-PJ,S-PJ should be preferred as a surgical option in the case of a uniformly dilated PD.

关键词： Chronic pancreatitis Surgical treatment Pancreaticojejunostomy Partington-Rochelle length of anastomosis

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