Chronic pancreatitis (CP) is a sequelae characterized by recurrent attacks of pancreatitis leading on to fibrosis and calcification of both ductal and parenchymal elements of the pancreas. Most of these, if left untreated at the right time, will lead on to burnt-out pancreas with complete atrophy of the parenchyma, leading on to endocrine/exocrine insufficiency. The pain in such patients is most likely due to ductal hypertension, parenchymal hypertension, and head mass causing perineural inflammation. Puestow procedure (longitudinal pancreaticojejunostomy) is the surgery of choice in selected patients with ductal hypertension where decompression of the duct provides symptomatic relief. Performance of such procedures in children by minimal access laparoscopic method is still evolving. We report a series of three patients (aged 10, 12, and 16 years) diagnosed with CP and successfully managed by laparoscopic Puestow procedure.
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http://dx.doi.org/10.4103/jiaps.JIAPS_235_18 | DOI Listing |
J Surg Case Rep
October 2024
Department of General Surgery, Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, Brazil.
J Clin Med Res
April 2024
Department of General Surgery, Rambam Medical Center, Haifa, Israel.
Pancreatoduodenectomy (PD) is a very complex and highly challenging operation for surgeons worldwide. It is the surgical procedure of choice for the management of benign and malignant diseases of the periampullary region. Although mortality rate following this complicated surgery has fallen to 1-3%, morbidity rate following PD remains high, with almost 30-40% of patients developing at least one complication.
View Article and Find Full Text PDFChildren (Basel)
January 2024
Department of Paediatric Surgery, Kings College Hospital, London SE5 9RS, UK.
Paediatric chronic pancreatitis (CP) is a rare and debilitating pathology that often requires invasive diagnostics and therapeutic interventions either to address a primary cause such as a pancreaticobiliary malunion or to deal with secondary complications such as chronic pain. Endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic ultrasound (EUS) are two endoscopic modalities that have an established diagnostic role in paediatric CP, and their therapeutic utilisation is increasing in popularity. Surgical decompression of the obstructed and dilated pancreatic duct plays a role in alleviating pancreatic duct hypertension, a common association in CP.
View Article and Find Full Text PDFAm J Case Rep
January 2024
Division of GI/Endocrine Surgery, Department of Surgery, Columbia University Irving Medical Center, New York City, NY, USA.
BACKGROUND The goal of surgical procedures in chronic pancreatitis is to establish drainage of the duct throughout the gland as well as resect any inflammatory masses if present. Conventionally, for patients with a dilated pancreatic duct without inflammatory masses, a drainage procedure in the form of a longitudinal pancreatojejunostomy (or Partington-Rochelle modification of the Puestow procedure) is the procedure of choice. CASE REPORT In present case, a patient with chronic pancreatitis was evaluated for surgical management, but extensive intraductal and parenchymal pancreaticolithiasis throughout the entire gland considerably restricted access to the duct.
View Article and Find Full Text PDFKhirurgiia (Mosk)
February 2023
Dagestan State Medical University, Makhachkala, Russia.
Objective: To analyze treatment outcomes in patients with various forms of chronic pancreatitis.
Material And Methods: We analyzed 434 patients with chronic pancreatitis. These ones underwent 2879 different examinations to determine morphological type of pancreatitis and dynamics of pathological process, as well as substantiate treatment strategy and functional monitoring of various organs and systems.
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