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Etiology, Diagnosis, and Modern Management of Chronic Pancreatitis: A Systematic Review.
JAMA Surg
June 2023
Beth Israel Deaconess Medical Center, Boston, Massachusetts.
Importance: The incidence of chronic pancreatitis is 5 to 12 per 100 000 adults in industrialized countries, and the incidence is increasing. Treatment is multimodal, and involves nutrition optimization, pain management, and when indicated, endoscopic and surgical intervention.
Objectives: To summarize the most current published evidence on etiology, diagnosis, and management of chronic pancreatitis and its associated complications.
Comparative Efficacy of Bilateral Thoracoscopic Splanchnicectomy for Intractable Pain Secondary to Pancreatic Cancer vs Chronic Pancreatitis.
J Am Coll Surg
April 2017
Department of Surgery, University of Louisville, Louisville, KY. Electronic address:
Background: Splanchnicectomy has been evaluated for treatment of chronic pain in both pancreatic cancer and chronic pancreatitis patients, although its efficacy has not been compared in these 2 patient populations. This study aimed to compare bilateral thoracoscopic splanchnicectomy in treatment of abdominal pain secondary with pancreatic cancer and chronic pancreatitis.
Study Design: A University of Louisville database was evaluated from July 1998 to March 2016 for patients undergoing bilateral thoracoscopic splanchnicectomy for intractable pain secondary to pancreatic cancer (n = 48) or chronic pancreatitis (n = 75).
Preoperative opioid use and the outcome of thoracoscopic splanchnicectomy in chronic pancreatitis: a systematic review.
Surg Endosc
February 2014
Department of Surgery, Academic Medical Center, P.O. Box 22660, 1100 DD, Amsterdam, The Netherlands,
Background: Thoracoscopic splanchnicectomy (TS) is a minimally invasive intervention to relieve pain in patients with chronic pancreatitis (CP) with equivocal results. Preoperative opioid use seems to impair TS outcome but this has not been investigated in a systematic matter.
Methods: We searched PubMed, EMBASE, and The Cochrane Library for studies on the outcome of TS in CP patients.
Prospective evaluation of pain control and quality of life in patients with chronic pancreatitis following bilateral thoracoscopic splanchnicectomy.
Surg Endosc
October 2013
Department of Anesthesiology and Intensive Care, Medical Center for Postgraduate Education, Ul. Czerniakowska 231, 00-416, Warsaw, Poland,
Background: Abdominal pain in chronic pancreatitis (CP) is the most common symptom with a highly unfavorable impact on the quality of life. It has been shown that bilateral thoracoscopic splanchnicectomy (BTS) may produce marked pain relief for the majority of patients. The aim of this study was to evaluate the effectiveness of BTS in pain control and quality-of-life improvement in patients with a severe form of CP.
View Article and Find Full Text PDFBilateral thoracoscopic splanchnicectomy for pain in patients with chronic pancreatitis impairs adrenomedullary but not noradrenergic sympathetic function.
Surg Endosc
August 2012
Department of Surgery, Radboud University Nijmegen Medical Centre, P.O. Box 9100, 6500 HB Nijmegen, The Netherlands.
Background: Bilateral thoracoscopic splanchnicectomy (BTS) is a well-known technique to alleviate intractable pain in patients with chronic pancreatitis. BTS not only disrupts afferent fibers from the pancreas that mediate pain but also postganglionic sympathetic fibers, which originate in segments T5-T12 and which innervate the vasculature of the liver, pancreas, and the adrenal gland. The purpose of this study was to assess whether and how BTS affects sympathetic noradrenergic and adrenomedullary function in patients with chronic pancreatitis.
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